PMID- 11463544
OWN - NLM
STAT- MEDLINE
DCOM- 20011004
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 20
IP  - 2
DP  - 2001 Aug
TI  - The importance of grade 2 ischemic mitral regurgitation in coronary artery bypass 
      grafting.
PG  - 276-81
AB  - 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.
FAU - Ryden, T
AU  - Ryden T
AD  - Department of Cardiothoracic Surgery Sahlgrenska University Hospital, Goteborg, 
      Sweden.
FAU - Bech-Hanssen, O
AU  - Bech-Hanssen O
FAU - Brandrup-Wognsen, G
AU  - Brandrup-Wognsen G
FAU - Nilsson, F
AU  - Nilsson F
FAU - Svensson, S
AU  - Svensson S
FAU - Jeppsson, A
AU  - Jeppsson A
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - *Coronary Artery Bypass
MH  - Coronary Disease/*complications/*surgery
MH  - Echocardiography, Doppler
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/diagnostic imaging/*etiology/*surgery
MH  - Postoperative Period
EDAT- 2001/07/21 10:00
MHDA- 2001/10/05 10:01
CRDT- 2001/07/21 10:00
PHST- 2001/07/21 10:00 [pubmed]
PHST- 2001/10/05 10:01 [medline]
PHST- 2001/07/21 10:00 [entrez]
AID - S1010-7940(01)00770-9 [pii]
AID - 10.1016/s1010-7940(01)00770-9 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2001 Aug;20(2):276-81. doi: 
      10.1016/s1010-7940(01)00770-9.