Isolated off-pump coronary artery bypass grafting corrects moderate ischemic mitral regurgitation:a propensity-matched study
Xiao Fucheng
Li Chengnan
Qiao Zhiyu
Ge Yipeng
Cheng Lijian
Hu Haiou
Zhu Junming
Abstract：Objective To observe the changing process of unrepaired moderate ischemic mitral regurgitation after isolated off-pump coronary artery bypass grafting and to evaluate the impact on in-hospital outcomes and survival.Methods From August 2013 to July 2017,clinical records of 31 consecutive patients with coronaryartery disease and moderate ischemic mitral regurgitation who underwent isolated off-pump coronary artery bypass grafting in Beijing Anzhen Hospital,Capital Medical University were collected.Thirty of them (96.8％) were matched with 60 control patients without mitral regurgitation who had the same procedure using the propensity score matching method to obtain risk-adjusted outcome comparison.Composite in-hospital outcomes (in-hospital death,myocardial infarction,stroke,intra-aortic balloon pump insertion,prolonged ventilation) and survival were analyzed.Changing process of unrepaired mitral regurgitation was analyzed using the longitudinal data analysis of post-bypass echocardiograms from those patients.Results Mitral regurgitation was moderate in 29％,mild in 53％ and trace or absent in 18％ immediately postoperatively.No significant change was observed in the proportion of each mitral regurgitation severity during follow-up (P =0.88).Although left ventricular end-diastolic diameter remained unchanged(P =0.68),there was an increase tendency of left ventricular ejection fraction after surgery (P=0.07).Composite in-hospital endpoints[13.3％ (4/30) vs 15.0％ (9/60)] and the 4-year survival rate (95％ vs 100％) were similar in patients with or without ischemic mitral regurgitation(P ＞0.05).Conclusion Moderate ischemic mitral regurgitation can be sustainably relieved by isolated coronary artery bypass grafting in most patients;the in-hospital outcomes and survival are satisfactory.
Keywords：Mitral valve insufficiencyCoronary artery bypass graftingMyocardial ischemia
Publication Date：2018-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1308-1312 )