Short and long term curative efficacy of CABG, MVP combined operation in patients with coronary heart disease with moderate ischemic mitral regurgitation / 解放军医学杂志

ABSTRACT

Objective To observe the short and long term efficacy of coronary artery bypass grafting (CABG), mitral valve annuloplasty (MVP) combined operation in patients with coronary heart disease with moderate ischemic mitral regurgitation comparing with simple CABG operation, and explore the best treatment and provide reference for clinical treatment. Method 115 patients with coronary heart disease complicated with moderate ischemic mitral regurgitation, admitted from September 2010 to September 2017 in General Hospital of Northern Theater Command, of PLA, were enrolled in present study. Of the 115 patients, 69 underwent coronary artery bypass grafting surgery (CABG group), and 46 underwent coronary artery bypass grafting and mitral valve annuloplasty combined surgery (CABG+MVP group). The short and long term outcomes of the two groups were compared and analyzed. The short term outcomes included clinical indicators [left atrium diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), systolic pulmonary artery pressure (sPAP), mitral regurgitation area, NYHA cardiac function classification) and the incidence of perioperative events. The long term outcomes included the cumulative survival rate and the exemption rate of cardiovascular and cerebrovascular events. Results The operation was successful in both groups. Perioperative mortality was 8 cases, including 4 cases in CABG group (5.7%) and 4 cases in CABG+MVP group (8.6%). There was no significant difference between the two groups (P>0.05). LVESD (P=0.009), mitral regurgitation (P0.05). The cumulative survival rate (P=0.205) and the exemption rate of cardiovascular and cerebrovascular events (P=0.535) had no significant difference between the two groups. Conclusions For treatment of coronary heart disease with moderate ischemic mitral regurgitation, the CABG+MVP group was superior to the CABG group, but not on long term efficacy, which can effectively improve the mitral regurgitation and NYHA cardiac function classification of patients. However, follow-up observation was still needed.