PMID- 21914304
OWN - NLM
STAT- MEDLINE
DCOM- 20130318
LR  - 20110914
IS  - 0529-5815 (Print)
IS  - 0529-5815 (Linking)
VI  - 49
IP  - 6
DP  - 2011 Jun 1
TI  - [The outcomes of restrictive mitral annuloplasty and coronary artery bypass 
      grafting for ischemic mitral regurgitation and reverse left ventricular 
      remodeling].
PG  - 530-4
AB  - OBJECTIVE: To retrospectively summarize and analyze the short and mid term 
      follow-up outcomes of combined coronary artery bypass grafting (CABG) and 
      restrictive mitral annuloplasty in curing ischemic cardiomyopathy and ischemic 
      mitral regurgitation (IMR), and to study its effect on reverse left ventricular 
      remodeling. METHODS: From January 2000 to June 2008, 111 patients of coronary 
      artery disease with moderate to severe IMR underwent combined CABG and 
      restrictive mitral annuloplasty, downsizing by 1-2 ring sizes. There were 81 male 
      and 30 female patients. The age ranged from 36 to 83 years with a mean of (63 +/- 
      18) years. Preoperative transthoracic echocardiography showed minimal to moderate 
      IMR in 7 cases, moderate to severe in 65 cases and severe in 39 cases. The left 
      arterial diameter (LAD) was (58 +/- 6) mm, left ventricular end-diastolic diameter 
      (LVEDD) was (61 +/- 8) mm, left ventricular ejection fraction (LVEF) was 46% +/- 6%. 
      Serial studies were performed to assess the survival rate, the extent of mitral 
      regurgitation (MR), LVEF, the leaflet coaptation height, LAD, LVEDD, New York 
      Heart Association (NYHA) functional class. RESULTS: Hospital mortality was 2.7% 
      (3 cases). Each case received an undersized ring. Intraoperative transesophageal 
      echocardiography showed that no regurgitation in 69 cases, minimal in 34 cases, 
      minimal to moderate in 5 cases, moderate to severe in 3 cases which received 
      mitral valve replacement. The 3-, 12- and 24-month survival rate was 96.2%, 93.5% 
      and 89.7% respectively. Mitral regurgitation grade decreased after the operative 
      procedure (P < 0.01). LVEF increased from (46 +/- 6)% to (53 +/- 6)% (24 months 
      follow-up) (P < 0.01). LAD decreased from (58 +/- 6) mm to (46 +/- 6) mm (24 months 
      follow-up) (P < 0.01). LVEDD decreased from (61 +/- 8) mm to (48 +/- 10) mm (24 
      months follow-up) (P < 0.01). There was no significant decline of LVEDD in 18 
      cases (16.2%) whose preoperative mean LVEDD was (69 +/- 9) mm. NYHA functional 
      class improved after operative procedures (P < 0.01). At 24 months follow-up, 2 
      cases received valvular replacement. CONCLUSIONS: Combined CABG and restrictive 
      mitral annuloplasty is a feasible and effective treatment for IMR, the short and 
      mid term outcomes are satisfactory, and a significant reduction of LVEDD and an 
      increase of LVEF due to reverse ventricular remodeling were observed.
FAU - Wang, Rui
AU  - Wang R
AD  - Nanjing Cardiovascular Hospital, Nanjing Medical University, Nanjing 210006, 
      China.
FAU - Chen, Xin
AU  - Chen X
FAU - Xu, Ming
AU  - Xu M
FAU - Wang, Li-ming
AU  - Wang LM
FAU - Jiang, Ying-shuo
AU  - Jiang YS
FAU - Liu, Pei-sheng
AU  - Liu PS
LA  - chi
PT  - English Abstract
PT  - Journal Article
PL  - China
TA  - Zhonghua Wai Ke Za Zhi
JT  - Zhonghua wai ke za zhi [Chinese journal of surgery]
JID - 0153611
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Artery Bypass
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Annuloplasty/*methods
MH  - Mitral Valve Insufficiency/*surgery
MH  - Myocardial Ischemia/*surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Ventricular Remodeling
EDAT- 2011/09/15 06:00
MHDA- 2013/03/19 06:00
CRDT- 2011/09/15 06:00
PHST- 2011/09/15 06:00 [entrez]
PHST- 2011/09/15 06:00 [pubmed]
PHST- 2013/03/19 06:00 [medline]
PST - ppublish
SO  - Zhonghua Wai Ke Za Zhi. 2011 Jun 1;49(6):530-4.