| The importance of grade 2 ischemic mitral regurgitation in coronary artery bypass grafting. | |
| | |
MedLine Citation:
|
PMID: 11463544 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To study if grade 2 ischemic mitral regurgitation (MR) influences outcome after coronary artery bypass grafting (CABG). METHODS: Results of all CABG patients with grade 2/4 ischemic MR operated during 1995--1998 (n = 89) were compared with all CABG patients without MR (n = 4709) during the same period. To further evaluate patients with grade 2 ischemic MR, a case-control study focusing on functional status was performed. Control patients without MR (n = 89) were matched for age, gender and left ventricular ejection fraction. All patients were interviewed regarding angina symptoms and functional status. RESULTS: Survival according to Kaplan--Meier at 1 and 3 years were inferior in the MR group compared to all CABG patients (91 vs 96% and 84 vs 92%, respectively (P = 0.0017). However, MR patients were older (68 +/- 9 vs 65 +/- 9 years (mean +/- SD), P = 0.008) and had an inferior preoperative left ventricular ejection fraction (42 +/- 14 vs 58 +/- 14%, P < 0.0001). In the case-control study, New York Heart Association (NYHA) class and Higgins' risk score differed preoperatively between the MR group and controls. Neither 30-day mortality (4,5% in both groups) nor survival at 1 (91 vs 93%) and 3 years (84 vs 88%) differed significantly. NYHA class and angina class (Canadian Cardiovascular Society, CCS) improved similarly in both groups. Postoperatively, 62% of the patients in the MR group had reduced, 36% unchanged and 2% increased MR. CONCLUSIONS: CABG on patients with grade 2 ischemic MR reduces angina pectoris and improves functional status to the same extent as in CABG patients without MR. Postoperative morbidity and mortality do not differ significantly between the groups. Grade of MR is reduced or unchanged after CABG in patients with grade 2 ischemic MR. The study supports an operative strategy where grade 2 ischemic mitral regurgitation is treated by CABG alone but the result do not exclude that there might be individual patients that would benefit from a valvular or annular procedure in combination with CABG. How these patients should be identified remains unclear. |
| | |
Authors:
|
T Rydén; O Bech-Hanssen; G Brandrup-Wognsen; F Nilsson; S Svensson; A Jeppsson |
Related Documents
:
|
19033004 - Off-pump coronary artery bypass graft surgery in california, 2003 to 2005. 18702964 - The relationship between obesity and atherosclerotic progression and prognosis among pa... 16719994 - Coronary artery stenosis. 10180374 - Geographic variation in the utilization and choice of procedures for treating coronary ... 23358434 - Integration of nodal and bmp signals in the heart requires foxh1 to create left-right d... 9727674 - Atrial dispersion of refractoriness. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 20 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2001 Aug |
Date Detail:
|
Created Date: 2001-07-20 Completed Date: 2001-10-04 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
|
Languages: eng Pagination: 276-81 Citation Subset: IM |
Affiliation:
|
Department of Cardiothoracic Surgery Sahlgrenska University Hospital, Göteborg, Sweden. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Coronary Artery Bypass* Coronary Disease / complications*, surgery* Echocardiography, Doppler Female Humans Male Middle Aged Mitral Valve Insufficiency / etiology*, surgery*, ultrasonography Postoperative Period |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Combined mitral valve and coronary artery surgery: ischemic versus non-ischemic mitral valve disease...
Next Document: Does a hyperoncotic cardiopulmonary bypass prime affect extravascular lung water and cardiopulmonary...