| Percutaneous versus surgical revascularization in patients with ischemic mitral regurgitation. | |
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MedLine Citation:
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PMID: 21911806 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background- The proper way of revascularization remains controversial in patients with ischemic mitral regurgitation (IMR). We sought to compare the long-term results of percutaneous coronary intervention (PCI) and surgical revascularization in IMR. Methods and Results- From 1996 to 2008, 185 consecutive patients (132 men; age, 63±9 years) with significant IMR underwent PCI (PCI group) (n=66) or coronary artery bypass graft surgery (OP group) (n=119). In the OP group, 68 (57%) patients also underwent concomitant mitral annuloplasty. Significant IMR was defined as functional MR occurring >1 week after myocardial infarction with an effective regurgitant orifice area ≥0.2 cm(2). During a median follow-up of 54 months, there were 2 operative mortalities, 26 cardiac deaths, and 11 heart failure hospitalizations in the OP group and 22 cardiac deaths and 10 heart failure hospitalizations in the PCI group. The survival and cardiac mortality rates were not significantly different between the 2 groups, but event-free survival rates were significantly higher in the OP group. For the 45 propensity score-matched pairs, the risk of cardiac events was significantly lower in the OP group than in the PCI group (hazard ratio, 0.499; 95% CI, 0.251 to 0.990; P=0.043). Compared with patients who underwent coronary artery bypass graft surgery alone, event-free survival rates were significantly higher in those who underwent additional mitral annuloplasty. Conclusions- Compared with PCI, surgical revascularization is associated with an improved long-term event-free survival, and concomitant mitral annuloplasty should be considered in patients with significant IMR. |
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Authors:
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Duk-Hyun Kang; Byung Joo Sun; Dae-Hee Kim; Sung-Cheol Yun; Jong-Min Song; Suk Jung Choo; Cheol Hyun Chung; Jae-Kwan Song; Jae-Won Lee; Seong-Wook Park; Seung-Jung Park |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 124 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: S156-62 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Poongnap-dong, Songpa-ku, Seoul, Korea 138-736. dhkang@amc.seoul.kr. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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