PMID- 11713862
OWN - NLM
STAT- MEDLINE
DCOM- 20020215
LR  - 20190921
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 16
IP  - 1
DP  - 2001 Jan-Feb
TI  - Mitral valve repair in severe ischemic cardiomyopathy.
PG  - 79-82
AB  - BACKGROUND: Patients with ischemic mitral valve insufficiency (MR) and poor left 
      ventricular (LV) function present a high operative risk. Whether to repair or 
      replace these valves is controversial, while some suggest that heart transplant 
      offers a better solution. We investigated our early and late results in this 
      difficult subset of patients. METHODS: Between 1993-1999,115 patients underwent 
      mitral valve repair (MVR) in our department. Twenty-one patients had severe LV 
      dysfunction with ejection fraction < 25%. Mean age was 60 years (range 45-81). 
      Nineteen (90%) were in New York Heart Association (NYHA) Class IV, 7 (33%) 
      underwent emergency surgery, 3 (14%) were in cardiogenic shock, and 2 (10%) were 
      taken to the operating room under cardiopulmonary resuscitation. All underwent 
      coronary artery bypass grafting (CABG) in addition to MVR, with a mean number of 
      grafts 2.9 per patient. RESULTS: There were no early operative deaths. The 
      average stay in intensive care was 5.9 days (range 1-52). There were three late 
      deaths (14%). Follow-up evaluation up to 3 years showed marked improvement in 
      clinical status. Twelve (67%) patients are in NYHA Class I-II, and three (17%) in 
      Class III. Echocardiography revealed good function of the mitral valve in all, 
      although overall LV function did not change significantly. CONCLUSION: (1) MVR in 
      patients with severe ischemic cardiomyopathy can be accomplished with excellent 
      results. (2) There is marked symptomatic improvement in these patients, even 
      though LV function did not seem to be improved. (3) Long-term survival still 
      needs to be defined.
FAU - Bitran, D
AU  - Bitran D
AD  - Department of Cardiac Surgery and Cardiology, Shaare Zedek Medical Center, 
      Jerusalem, Israel. cts-szmc@szmc.org.il
FAU - Merin, O
AU  - Merin O
FAU - Klutstein, M W
AU  - Klutstein MW
FAU - Od-Allah, S
AU  - Od-Allah S
FAU - Shapira, N
AU  - Shapira N
FAU - Silberman, S
AU  - Silberman S
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Artery Bypass
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/etiology/*surgery
MH  - Myocardial Ischemia/*complications/surgery
MH  - Retrospective Studies
MH  - Risk
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/etiology
EDAT- 2001/11/21 10:00
MHDA- 2002/02/16 10:01
CRDT- 2001/11/21 10:00
PHST- 2001/11/21 10:00 [pubmed]
PHST- 2002/02/16 10:01 [medline]
PHST- 2001/11/21 10:00 [entrez]
AID - 10.1111/j.1540-8191.2001.tb00488.x [doi]
PST - ppublish
SO  - J Card Surg. 2001 Jan-Feb;16(1):79-82. doi: 10.1111/j.1540-8191.2001.tb00488.x.