Chest, Vol 81, 550-555, Copyright © 1982 by American College of Chest Physicians

ARTICLES

Mitral regurgitation in coronary artery disease

V Balu, S Hershowitz, AR Zaki Masud, JN Bhayana and DC Dean

Over a period of 5.25 years, 1,530 patients with coronary artery disease (CAD) underwent catheterization; 104 had associated mitral regurgitation (MR), and 60 had no complications. Twelve patients underwent coronary artery bypass graft surgery (CABG), with both pre- and postoperative angiograms. Nine of the 12 patients (75 percent) were in functional class 3 or 4. Left ventricular ejection fraction ranged from 34 to 75. The MR was considered severe (3+) in three, moderate (2+) in six, and trivial (1+) in three patients. Following CABG, all except two patients were in class 1. Of the 43 patients medically treated, 31 patients (72 percent) were in functional class 3 or 4. Angiographic results showed that five patients had 3+ MR, 14 had 2+ MR, and 24 had 1+ MR. The EF was less than 30 in 23 patients and greater than or equal to 30 in 20 patients, and left ventricular filling pressure was elevated. Twenty patients died, with a mean follow-up period of 11 months. Our study demonstrates that the surgically treated patients showed angiographic improvement in MR, improved functional status, and relief of symptoms compared with medically treated patients. We believe that a subset of patients with MR and CAD would benefit with CABG.

This article has been cited by other articles:

				K. A Osman, R. A Saad, M. M Osman, and M. H Ahmed Metabolic syndrome and ischemic mitral regurgitation: other piece of the jigsaw. Asian Cardiovasc Thorac Ann, August 1, 2006; 14(4): 354 - 355. [Full Text] [PDF]

				D. R. Wong, A. K. Agnihotri, J. W. Hung, G. J. Vlahakes, C. W. Akins, A. D. Hilgenberg, J. C. Madsen, T. E. MacGillivray, M. H. Picard, and D. F. Torchiana Long-Term Survival After Surgical Revascularization for Moderate Ischemic Mitral Regurgitation Ann. Thorac. Surg., August 1, 2005; 80(2): 570 - 577. [Abstract] [Full Text] [PDF]

				H. R. Mallidi, M. P. Pelletier, J. Lamb, N. Desai, J. Sever, G. T. Christakis, G. Cohen, B. S. Goldman, and S. E. Fremes Late outcomes in patients with uncorrected mild to moderate mitral regurgitation at the time of isolated coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 636 - 644. [Abstract] [Full Text] [PDF]

				R. C. Gorman, J. H. Gorman III, and L. H. Edmunds Jr. Ischemic Mitral Regurgitation Card. Surg. Adult, January 1, 2003; 2(2003): 751 - 769. [Full Text]

				A. Al-Tabbaa, R. M. Gonzalez, and D. Lee The role of state-of-the-art echocardiography in the assessment of myocardial injury during and following cardiac surgery Ann. Thorac. Surg., December 1, 2001; 72(6): S2214 - 2218. [Abstract] [Full Text] [PDF]

				L. Aklog, F. Filsoufi, K. Q. Flores, R. H. Chen, L. H. Cohn, N. S. Nathan, J. G. Byrne, and D. H. Adams Does Coronary Artery Bypass Grafting Alone Correct Moderate Ischemic Mitral Regurgitation? Circulation, September 18, 2001; 104(90001): I-68 - 75. [Abstract] [Full Text] [PDF]