Assessment of early outcome of coronary artery bypass grafting with and without mitral valve surgery in moderate ischemic mitral regurgitation: A multicenter comparative cohort study

Abstract

Background: Some experts believe that revascularization alone for moderate ischemic mitral regurgitation, due to improvements in global and regional left ventricular function and geometry after coronary artery bypass grafting (CABG), can decrease rates of mitral regurgitation, however, the value of adding mitral valve repair or not to the CABG surgery remains controversial. Aim: To compare the early peri-operative results of surgical management of moderate ischemic mitral regurgitation by revascularization alone versus revascularization plus mitral valve surgery. Patients and Methods: This prospective cohort comparative study was conducted at Suez Canal University Hospitals, and Suez Hospital for Health Insurance, Cardiac Surgery Department from January 2020 to January 2023. This study was conducted on 100 patients with IHD undergoing CABG with moderate ischemic mitral regurge attending our clinic in Suez Canal University Hospital and Cardiac Surgery Department in Suez Hospital for Health Insurance. Results: The New York Heart Association (NYHA) classification showed statistically significant difference between both groups ( P=0.008 ). Also, group I had a higher mean of left ventricular ejection fraction than group II with statistically insignificant differences ( P>0.05 ). Group I had significantly lower segmental wall-motion abnormalities than group II with statistically significant differences ( P=0.042 ). Also, the severity of mitral regurgitation was significantly lower among group I than group II ( P=0.028 ). Among group I, the severity of NYHA classification distribution showed a statistically significant decrease ( P<0.001 ). Conclusion: Moderate mitral regurgitation in patients undergoing isolated CABG adversely NYHA functional class and mitral regurgitation does not reliably improve after CABG alone.