Short-term outcomes of simultaneous coronary artery bypass surgery and mitral valve repair for ischemic mitral insufficiency

Zhbanov I.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0001-7321-6214

Revishvili G.A.

Petrovsky Russian Research Center of Surgery

Van E.Yu.

Petrovsky Russian Research Center of Surgery

Kulagina T.Yu.

Petrovsky National Research Centre of Surgery

ORCID: 0000-0001-6165-6474

Aleksandrova E.N.

Petrovsky Russian Research Center of Surgery

Mazitova D.I.

Petrovsky Russian Research Center of Surgery

Uryuzhnikov V.V.

Petrovsky Russian Research Center of Surgery

Shabalkin B.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-0409-4521

Short-term outcomes of simultaneous coronary artery bypass surgery and mitral valve repair for ischemic mitral insufficiency

Authors:

Zhbanov I.V., Revishvili G.A., Van E.Yu., Kulagina T.Yu., Aleksandrova E.N., Mazitova D.I., Uryuzhnikov V.V., Shabalkin B.V.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(2): 135‑144

DOI: 10.17116/kardio202114021135

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To cite this article:

Zhbanov IV, Revishvili GA, Van EYu, et al. . Short-term outcomes of simultaneous coronary artery bypass surgery and mitral valve repair for ischemic mitral insufficiency. Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(2):135‑144. (In Russ.)
https://doi.org/10.17116/kardio202114021135

Подписка 2025-2 (Russian Journal of Cardiology and Cardiovascular Surgery)

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OBJECTIVE

To analyze the immediate outcomes of surgical treatment of patients with coronary artery disease complicated by ischemic mitral regurgitation (IMR) depending on its grade and type of surgery.

MATERIAL AND METHODS

A retro- and prospective analysis included 159 patients after isolated coronary artery bypass grafting (CABG) and simultaneous coronary artery bypass surgery and mitral valve repair. All patients were divided into 3 groups depending on the type of intervention: 43 (27.0%) patients with mild-to-moderate IMR underwent isolated CABG (group 1), 76 (47.8%) patients with moderate-to-severe IMR — CABG and mitral valve surgery (group 2). The control third group included 40 (25.2%) patients without mitral regurgitation who underwent isolated CABG. Intraoperative and postoperative variables, as well as perioperative morbidity and in-hospital mortality were analyzed.

RESULTS

There were no significant between-group differences in perioperative morbidity. Perioperative myocardial infarctions were absent. Incidence of postoperative heart failure followed by inotropic support was similar in all groups (9.2, 8 and 7.5% in groups 1, 2 and 3, respectively) (p>0.05). One (0.6%) patient in the second group required mitral valve replacement due to ineffective annuloplasty. There was no in-hospital mortality in all groups. We found no significant between-group differences in postoperative ICU-stay and hospital-stay.

CONCLUSION

Mitral valve surgery combined with myocardial revascularization in patients with IMR does not increase the risk of perioperative complications and in-hospital mortality compared to isolated CABG regardless severity of mitral insufficiency.

Keywords:

coronary artery disease

ischemic mitral regurgitation

coronary artery bypass grafting

myocardial revascularization

mitral valve annuloplasty

Authors:

Zhbanov I.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0001-7321-6214

Revishvili G.A.

Petrovsky Russian Research Center of Surgery

Van E.Yu.

Petrovsky Russian Research Center of Surgery

Kulagina T.Yu.

Petrovsky National Research Centre of Surgery

ORCID: 0000-0001-6165-6474

Aleksandrova E.N.

Petrovsky Russian Research Center of Surgery

Mazitova D.I.

Petrovsky Russian Research Center of Surgery

Uryuzhnikov V.V.

Petrovsky Russian Research Center of Surgery

Shabalkin B.V.

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-0409-4521

Received:

22.01.2021

Accepted:

10.02.2021

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