MITRAL VALVE REPAIR FOR ISCHEMIC MITRAL REGURGITATION: EXPERIENCE AT A TERTIARY CARE HOSPITAL

Abstract

Objective: To know the outcomes of mitral valve repair for ischemic mitral
regurgitation and its medium term survival.
Methodology: This retrospective study was carried out at a tertiary care hospital.
All those patients who underwent mitral valve repair for ischemic mitral
regurgitation between January 2007 and January 2009 were included in the
study. Patients were followed at regular 3 monthly intervals and time related
survival curves developed using Statistical Package for Social Sciences.
Mortality was considered as the primary outcome during the follow up period.
Results: A total of 19 patients (n=19) with a mean age 53.84±6.85 years
underwent repair for mitral valve for ischemic regurgitation. These included
13(68.4%) male patients while 6(31.6%) were females. All the patients had
moderate to severe mitral regurgitation on echocardiography preoperatively. All
the patients underwent concomitant Coronary Artery Bypass Grafting. The in
hospital stay was 19.79±4.35 days with no in hospital mortality. Patients were
followed up for 36 months. During followed up, 2 (10%) patients died, one at 25th
month and the other at the 35th month both due to heart related causes. A Coxregression model showed age [OR=1.185, (95%CI, 0.994 to 1.412, p=0.058)],
low EF [OR=1.02, (95% CI,0.897 to 1.157, p=0.773)] and longer cross clamp
time [OR=1.05, (95% CI, 0.763 to 121.723, p=0.351)] to be predictors of
mortality.
Conclusion: Repair for mitral regurgitation post myocardial infarction can be
undertaken with acceptable mortality and provides good medium term results.
The repair should be done whenever the adjacent tissue is not diseased and
friable.