Abstract
Objective: to evaluate the immediate and long-term results of surgical treatment of various types of ischemic mitral regurgitation (IMR).
Material and methods.A retrospective study of patients with IMR (n = 101) was conducted. The median follow-up was 5 years. The patients were divided into 3 groups: group I (n = 31) – patients with type I IMR (isolated annulodilation), group II (n = 28) – patients with type II IMR (ischemic prolapse), group III (n = 42) – patients with type IIIb IMR (restriction of leaflet mobility). All patients underwent correction of mitral insufficiency in cardiopulmonary bypass. The vast majority of patients underwent combined intervention on the mitral valve and coronary arteries.
Results. Mortality was 5.9%. There were no dead patients in group I. In group I, 5 (4.9%) patients died in the postoperative period, and 3 of them were operated on for acute MI. In group III, 1 (1.0%) patient died. Oversizing correction with semi-rigid ring in patients with type I IMR demonstrated the best long-term results. The degree of mitral regurgitation in the immediate period in patients of group I improved from 2.92 ± 0.45 to 0.79 ± 0.31 degree, in patients of group II from 3.09 ± 0.42 to 0.73 ± 0.25, in patients of group III from 2.94 ± 0.28 to 0.72 ± 0.34. According to the results of the study, risk factors for hospital mortality (EuroSCORE I, age, time of cardiopulmonary bypass and time of aortic clamping) were identified with the obtaining of prognostic models, and repair failure predictors in the long-term period were received (LV end diastolic diameter > 65 mm).
Conclusion. This study analyzes the immediate and long-term results of surgical treatment of various types of IMR with the obtaining of algorithm for surgical treatment.
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About the authors
- Ivan I. Skopin, Dr. Med. Sc., Professor, Head of Department, Director of Institute of Coronary and Vascular Surgery ORCID
- Aleksandr V. Vavilov, Cardiovascular Surgeon, ORCID
- Inessa V. Slivneva, Cand. Med. Sc., Researcher, Ultrasound Diagnostician, ORCID
- Mikhail S. Latyshev, Cand. Med. Sc., Researcher, ORCID
- Dar’ya V. Murysova, Researcher, ORCID
