Document Detail


Results of coronary bypass and valve operations for mitral valve regurgitation.
MedLine Citation:
PMID:  17911067     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Combined coronary bypass grafting and valve procedures for mitral valve regurgitation result in poor outcomes, but the impact of the etiology of valve regurgitation on operative and long-term outcomes is not well defined. A retrospective analysis of 468 patients who had combined coronary bypass grafting and valve operations for mitral regurgitation showed that 78% had valve repairs and 22% had replacements for ischemic (45%) or degenerative (55%) disease. Predictors of operative mortality were ischemic mitral regurgitation, failure to use the internal mammary artery for grafting, severe coronary disease, acute myocardial infarction, low ejection fraction, advanced heart failure, emergency operation, and mitral valve replacement. The 5-year survival rates for propensity-matched patients with ischemic or degenerative disease were similar (66%). Low ejection fraction (< 35%), advanced age (> 67 years), valve replacement surgery, residual mitral regurgitation, and severe coronary artery disease were predictors of poor long-term outcome. Although the operative outcomes of ischemic mitral regurgitation were poor compared to those of degenerative disease, the long-term survival was similar in both groups of propensity-matched patients. Left ventricular remodeling, an optimal valve procedure without residual mitral regurgitation, and left ventricular function are more important determinants of long-term outcome than the etiology of valve regurgitation.
Authors:
Srikrishna Sirivella; Isaac Gielchinsky
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  15     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-03     Completed Date:  2008-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  396-404     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular and Thoracic Surgery, Newark Beth Israel Medical Center, University of Medicine & Dentistry of New Jersey, Newark, NJ, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Surgical Procedures* / adverse effects,  mortality
Coronary Artery Bypass* / adverse effects,  mortality
Coronary Disease / complications,  mortality,  physiopathology,  surgery*
Emergency Treatment / adverse effects
Female
Heart Failure / complications,  mortality
Heart Valve Prosthesis Implantation* / adverse effects,  mortality
Hospital Mortality
Humans
Kaplan-Meiers Estimate
Length of Stay
Male
Mitral Valve Insufficiency / complications,  etiology,  mortality,  physiopathology,  surgery*
Myocardial Infarction / complications,  mortality
Myocardial Ischemia / complications,  mortality
Retrospective Studies
Risk Factors
Severity of Illness Index
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Dysfunction, Left / complications,  mortality
Ventricular Dysfunction, Right / complications,  mortality
Ventricular Remodeling

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