Original articleCardiovascularA Prospective Study of Predicting Factors in Ischemic Mitral Regurgitation Recurrence After Ring Annuloplasty
Section snippets
Patient Population
Between May 2002 and March 2004, 1617 patients were referred to Day General Hospital for elective first-time coronary artery bypass grafting (CABG). After quantitative echocardiographic measurements, 121 patients with chronic 3+ and 4+ IMR on a scale of 1 to 4, as judged by a consensus of 2 observers, underwent coronary angiography, followed by CABG and mitral annuloplasty. All the patients had had a MI at least 6 weeks previously.
The patients were evaluated with intraoperative
Results
There were 5 postoperative in-hospital deaths. During follow-up, 14 patients died: 12 of cardiac causes (heart failure in 7, sudden death in 3, acute ischemia in 2) and 2 of noncardiac causes (accident in 1, leukemia in 1). Analysis was done on 95 patients.
The mean age of the patients was 54.6 ± 11.3 years and 74 (77.9%) were men. MR was at grade 3 in 29 patients (30.5%) and at grade 4 in 66 (69.5%). The subjects had a mean iPMD of 17.3 ± 6.0 mm, annular size of 38.3 ± 3.1 mm, coaptation depth
Comment
Indubitably, further research is required to help improve the prognosis of patients with IMR. As mentioned earlier, mitral annuloplasty is the surgical treatment of choice for patients with IMR. In the current study, 24.2% of the patients, who had successful mitral annuloplasty, showed MR recurrence (2+ or more) within 22.35 months of follow-up, an incidence almost similar to that described by other investigators [3, 4, 5]. Because annuloplasty has a considerable rate of failure and mitral
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