Repair vs. conservative treatment for ischemic patients with a moderate degree of mitral incompetence

Resumo

Background: Ischemic heart diseases are often associated with a moderate degree of mitral incompetence. The optimal treatment of this condition is still controversial. benefits of repairing moderate mitral incompetence in ischemic patients are uncertain. Objectives: compare outcomes of treating ischemic patients with moderate mitral incompetence either by isolated CABG versus CABG with mitral repair. Patients and methods: We prospectively studied 60 consecutive ischemic patients with a moderate degree of mitral incompetence who were surgically treated at the National Heart Institute between the period of April 2021 to March 2022. 30 patients had isolated CABG surgery while the other 30 patients underwent CABG together with a restrictive mitral annuloplasty ring. Complete revascularization was done for all candidates. After one-year follow-up results were compared to each other. Results: There were no mortalities throughout the study, male: female ratio was similar without any significant difference, mean age was (59.16 ± 3.48 years) in group A and (59.43 ± 3.90 years) in group B without significant difference, Group B had a significantly longer cardiopulmonary bypass time (162.66 ± 8.53 minutes vs. 122.46 ± 6.68 minutes) and longer cross-clamp time (134.50 ± 8.43 minutes vs. 87.76 ± 20.32 minutes), the ICU stay time was significantly longer in group B (90.06 ± 22.39 hours vs 75.60 ± 22.31 hours), the total hospital stay time (9.46 ± 1.81days vs 8.53 ± 1.90 days) was significantly irrelevant. Conclusion: After a one-year follow-up, no evidence that combined CABG with valve repair has any advantages over isolated CABG in treating ischemic patients with moderate mitral incompetence.