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Ischemic mitral valve disease: classification and systemic approach to management

J H Oury1, J C Cleveland, C G Duran

  • 1Division of Cardiac Surgery, St. Patrick Hospital, Missoula, Montana 59802.

Journal of Cardiac Surgery
|March 1, 1994
PubMed

Insights

Mitral valve repair and replacement in coronary artery disease patients showed similar mortality. However, repaired valves experienced more structural dysfunction than replaced valves over time.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Adult Cardiac Surgery

Background:

  • Coronary artery disease (CAD) frequently coexists with mitral valve pathology.
  • Surgical management requires careful consideration of both conditions.
  • Optimal surgical strategy remains debated.

Purpose of the Study:

  • To compare outcomes of mitral valve repair versus replacement in patients with CAD.
  • To analyze long-term structural valve dysfunction in both groups.

Main Methods:

  • Retrospective review of 169 consecutive patients with CAD and mitral valve pathology.
  • Patients underwent either mitral valve repair (n=87) or replacement (n=82) with coronary artery bypass grafting.
  • Flexible ring annuloplasty and chordal-sparing techniques were employed.

Main Results:

  • No significant difference in operative mortality between repair and replacement groups.
  • Higher incidence of structural valve dysfunction in repaired mitral valves (6.0%) compared to replaced valves (0%).
  • Concomitant coronary artery bypass grafting performed in all patients.

Conclusions:

  • Mitral valve repair and replacement offer comparable short-term survival in high-risk CAD patients.
  • Long-term durability favors mitral valve replacement due to lower rates of structural valve dysfunction.

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