Back to 2022 Posters


Ischemic Mitral Regurgitation: To Repair Or Replace? Equivalent Outcomes In A Single Center
Joseph Charles Sweeney1, Amal Alotaibi2, Gene D. Porter1, Divya Avula1, Jaimin R. Trivedi1, Mark S. Slaughter1, Brian L. Ganzel1.
1University of Louisville, Louisville, KY, USA, 2University of Kentucky, Lexington, KY, USA.

OBJECTIVE: Recent reports on ischemic mitral valve (MV) regurgitation surgical strategies have suggested better hemodynamic performance with MV replacement (MVR) than MV repair (MVr) with no survival difference at 2 years. We evaluated the difference between MVR and MVr hemodynamic MV performance at 1 and 2 years post-operatively.
METHODS:
A retrospective single-center cardiac surgery database was queried for patients (aged >/= 18 years) requiring mitral valve surgery and concomitant CABG or previous PCI between January 2010 and June 2018. Patients were separated into two groups: MVr and MVR. Patients with mixed mitral valvular etiologies were excluded. Baseline characteristics, peri-operative and post-operative outcomes were evaluated using Wilcoxon and Chi-Square tests.
RESULTS:
A total of 111 patients (median age 66 years, 66% males) underwent an operation for ischemic mitral regurgitation. 62 (56%) had MVR and 49 (44%) had MVr. Both groups had > 80% concomitant CABG. The MVr group had lower EF (40% vs. 55%, p < 0.01), shorter cardiopulmonary bypass time and aortic cross-clamp time. In-hospital mortality (6% vs. 10%, p=1.00) and 1-year mortality (14% vs. 18%, p=0.17) were similar. Cardiac vessels intervened upon were similar between groups. Pre-op left ventricular internal diameter end-diastole was greater in the MVr group (5.6cm vs. 4.6cm, p<.01). At 1-year, the number of patients with moderate or greater mitral regurgitation was similar between the MVr and MVR groups (6% vs. 12%, p = 0.69). At 2-years the MVr and MVR groups had no difference in moderate or severe mitral regurgitation (7% vs. 13%, p = 0.68). One patient in the MVR group required reoperation 5 years postoperatively.
CONCLUSIONS:
Our findings demonstrate similar early mortality and mid-term mitral valve performance suggesting that MV repair should be considered an option in patients with ischemic MR requiring surgical revascularization.


Back to 2022 Posters