Abstract 2261: Long-term Survival After Coronary Revascularization With Or Without Mitral Valve Repair In Chronic Ischemic Mitral Regurgitation. A Propensity Analysis.
Good results are reported after the mitral valve (MV) repair for ischemic mitral regurgitation (MR).
The aim of the study was to assess results of the mitral annuloplasty (MVpl) in addition to CABG and to identify predictors of the overall survival after MVpl in long-term follow-up.
Methods. Between JAN 1999 and DEC 2006 318 consecutive pts, 61.7±8.74 years old, with chronic ischemic MR undergoing CABG with (MVpl; 209 pts) or without (NONpl; 109 pts) MV repair were prospectively followed for 4.4±1.93 years. A Cox proportional hazards model evaluated overall survival as a function of baseline age, sex, ejection fraction (EF), end-diastolic (EDVi) and end-systolic volume indices, MR jet area, left atrial area, atrial fibrillation, NYHA class, prior anterior or inferior myocardial infarction, medical comorbidities, MVpl, LV plasty, left main and 3 vessel disease, venous graft to LAD, no of grafts and year of operation. Treatment selection bias was controlled by deriving a propensity score for MVpl.
Results. Predictors of overall survival are presented in table⇓. The ROC curve analysis revealed serum creatinine>1.15mg/dL (sensitivity; specificity: 48.5; 81.0 resp.), EDVi > 80.6ml/m2 (82.8; 38.6) and EF<34.0% in MVpl pts (53.7; 67.9) and EF<39.0% in NONpl pts (70.5; 62.5) as cut-off values. There was no difference in baseline EF between groups.
Conclusion. MVpl has no impact on overall survival but it improves survival dependent on EF and can be safely added to CABG.