Document Detail


Initial report of off-pump coronary artery bypass surgery as sole therapy for moderate ischemic mitral regurgitation: operative and intermediate-term outcome.
MedLine Citation:
PMID:  15769731     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients undergoing on-pump coronary artery bypass surgery (CAB) with coexistent moderate ischemic mitral regurgitation (IMR) have a significant mortality rate compared to patients without MR. The mortality rate is elevated both perioperatively (0%-12% mortality), as well as over a 1- and 2-year postoperative period (15%-25%). It is thought that some patients are best served by off-pump CAB (OPCAB); however, outcomes have not been reported for such patients with coexistent moderate IMR. METHODS: We reviewed the independent database of patients undergoing OPCAB between 1995 and 2002 to find 989 patients, 17 (1.7%) of whom had moderate or moderately severe MR. Patients were contacted and clinical and echocardiographic data were obtained. RESULTS: The patient group consisted of 11 men and 6 women (age, 65 +/- 15 years). The study group had a PA pressure of 52 +/- 14, creatinine of 1.6 +/- 0.7, and left ventricular ejection fraction of 43 +/- 18. Nine patients (53%) had advanced New York Heart Association (class III-IV) heart failure. Mortality rates perioperatively and at 1, 2, and 3 years were 0%, 6.25% (1/16), 12.5% (2/16), and 38% (4/8), respectively. At the time of this report, no patient had returned for a reparative procedure. CONCLUSION: In patients felt to be best served by OPCAB with ischemic MR, operative and intermediate mortality rates are remarkably similar to those previously reported for on-pump series. These data underscore the continued need to understand which patients undergoing CAB require mitral valve problems to be addressed at the time of surgery.
Authors:
Kevin M Harris; Avinash Reddy; Dorothee Aepplii; Betsy Wilson; Robert W Emery
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  8     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2005  
Date Detail:
Created Date:  2005-03-16     Completed Date:  2006-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E89-93     Citation Subset:  IM    
Affiliation:
The Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA. kharris@mplsheart.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Output, Low / etiology,  physiopathology
Cardiovascular Diseases / complications
Coronary Artery Bypass, Off-Pump* / adverse effects,  mortality
Creatinine / blood
Diabetes Complications
Female
Follow-Up Studies
Humans
Male
Middle Aged
Mitral Valve Insufficiency / complications*,  physiopathology,  surgery*
Myocardial Ischemia / blood,  complications*,  physiopathology,  surgery*
Risk Factors
Severity of Illness Index
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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