Good long-term results are reported after the mitral valve (MV) repair for ischemic regurgitation.
The aim of the study
was to identify predictors of the overall survival after routine MV repair in patients with ischemic cardiomyopathy.
Methods.
164 patients, 60.9±8.66 years old, with chronic ischemic mitral regurgitation and left ventricle ejection fraction (EF) = 30.7±6.04 undergoing coronary bypass with or without MV repair were prospectively followed for 5.1±1.63 years. A Cox proportional hazards model evaluated overall survival as a function of baseline age, sex, EF, mitral regurgitation jet area, left atrial area, atrial fibrillation, NYHA class, prior anterior or inferior myocardial infarction, medical comorbidities, MV repair, left ventricular plasty, left main and 3 vessel disease, venous graft to left anterior descending artery, number of grafts and year of operation. Treatment selection bias was controlled by deriving a propensity score for mitral annuloplasty.
Results.
Predictors included in the Cox regression model of overall survival are presented in table
. The ROC curve analysis revealed EF <30.0, (sensitivity and specificity - 61.7% and 59.0%, respectively) and serum creatinine >1.17, (45.6% and 77.2%) as a cut-off values in the prediction of overall survival.
Conclusions.
There is no impact of the mitral annuloplasty on overall survival in these patients. MV repair can be safely added to coronary bypass grafting in patients with ischemic cardiomyopathy.
Multivariable Cox regression analysis results
Left ventricular restoration for ischemic cardiomyopathy and simultaneous implantation of left ventricular assist system actively aiming at bridge to recovery