PMID- 15336993
OWN - NLM
STAT- MEDLINE
DCOM- 20050711
LR  - 20161124
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 78
IP  - 3
DP  - 2004 Sep
TI  - Repair of ischemic mitral regurgitation does not increase mortality or improve 
      long-term survival in patients undergoing coronary artery revascularization: a 
      propensity analysis.
PG  - 794-9; discussion 794-9
AB  - BACKGROUND: The purpose of this study was to compare operative mortality and 
      midterm outcome of patients with ischemic mitral regurgitation (MR) undergoing 
      either coronary artery bypass grafting (CABG) alone or CABG with mitral valve 
      (MV) repair. METHODS: From 1996 to 2001, 51 consecutive patients underwent CABG 
      with MV repair for ischemic MR. All patients in this group were matched to 
      similar patients with ischemic MR undergoing CABG alone during the same 6-year 
      period using propensity analysis (considering 24 covariates, including severity 
      of MR and New York Heart Association [NYHA] class). RESULTS: Propensity score 
      matching yielded 51 closely matched control patients. Preoperative MR severity 
      was 3+ or 4+ in 94% of CABG with MV repair and 96% of CABG-alone patients, and 
      86% of patients in each group were NYHA class III or IV. Operative mortality was 
      3.9% +/- 2.8% in both groups. Survival was also similar between CABG with MV 
      repair and CABG alone at 1 year (84% +/- 5% versus 82% +/- 5%) and 3 years (70% 
      +/- 7% versus 71% +/- 7% (p = 0.43). Among survivors, NYHA class improved at 
      follow-up (50 +/- 20 months) from 3.4 +/- 0.7 to 1.7 +/- 1.0 for CABG with MV 
      repair (p < 0.001) and from 3.4 +/- 0.7 to 1.8 +/- 1.0 for CABG alone (p < 
      0.001). CONCLUSIONS: Operative mortality, midterm survival, and late functional 
      class were similar between two well-matched groups of patients undergoing CABG 
      for ischemic MR, differing only in the addition of MV repair. Whereas MV repair 
      can be added safely to CABG in this group of high-risk patients without 
      increasing mortality, its impact on late survival and functional class may be 
      limited.
FAU - Diodato, Michael D
AU  - Diodato MD
AD  - Division of Cardiothoracic Surgery, Washington University School of Medicine, St. 
      Louis, Missouri, USA.
FAU - Moon, Marc R
AU  - Moon MR
FAU - Pasque, Michael K
AU  - Pasque MK
FAU - Barner, Hendrick B
AU  - Barner HB
FAU - Moazami, Nader
AU  - Moazami N
FAU - Lawton, Jennifer S
AU  - Lawton JS
FAU - Bailey, Marci S
AU  - Bailey MS
FAU - Guthrie, Tracey J
AU  - Guthrie TJ
FAU - Meyers, Bryan F
AU  - Meyers BF
FAU - Damiano, Ralph J Jr
AU  - Damiano RJ Jr
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Aged
MH  - Coronary Artery Bypass/*statistics & numerical data
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Mitral Valve Insufficiency/complications/diagnostic imaging/*mortality/*surgery
MH  - Myocardial Ischemia/complications/diagnostic imaging/*surgery
MH  - Myocardial Revascularization/*statistics & numerical data
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2004/09/01 05:00
MHDA- 2005/07/12 09:00
CRDT- 2004/09/01 05:00
PHST- 2004/03/08 00:00 [accepted]
PHST- 2004/09/01 05:00 [pubmed]
PHST- 2005/07/12 09:00 [medline]
PHST- 2004/09/01 05:00 [entrez]
AID - S0003497504006393 [pii]
AID - 10.1016/j.athoracsur.2004.03.022 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2004 Sep;78(3):794-9; discussion 794-9. doi: 
      10.1016/j.athoracsur.2004.03.022.