Risk factors for the return of mitral regurgitation after coronary
artery bypass grafting and mitral valve reconstruction in patients with
Background and Aim: We aimed to identify risk factors for recurrent
mitral regurgitation in two surgical treatment groups: isolated coronary
artery bypass grafting (CABG) and CABG combined with mitral valve (MV)
repair in patients with moderate ischemic mitral regurgitation (IMR).
Methods: A single-centre, prospective, randomised study, which included
76 patients with ICM and moderate mitral regurgitation (MR). Study
included two groups: isolated CABG and CABG with MV repair (MVR).
Isolated annuloplasty was used to correct mitral insufficiency in the
CABG + MVR group. Results: Isolated CABG or CABG combined with MVR in
patients with ICM does not lead to a statistically significant
decreasing of MR in the long-term period compared to baseline values.
However, in one year after surgery, the degree of MR after combined
surgery is lower than the initial values. The identification of
predictors of the progression of IMR in ICM made it possible to
determine the threshold values for the effectiveness of MVR, and the
assessment of echocardiographic predictors for annuloplasty helps to
choose the right surgical tactic of patients. Conclusions: Coronary
revascularization with surgical of IMR in patients with ICM does not
increase the number of complications in the early postoperative period
compared to the group of isolated CABG. In patients with ICM and
moderate MR after isolated CABG, the progression of MR (MR of the 3rd
degree, initially 0%, after 12 months 31%, after 36 months 71%; p
<0.001) was observed even with an initially moderate expansion
of the fibrous ring of the MV.