Survival and Cardiovascular Outcomes of Patients With Secondary Mitral Regurgitation
The authors have concluded from a meta-analysis of over 45,000 patients, mitral regurgitation in the presence of LV dysfunction (either ischaemic cardiomyopathy or idiopathic causes) is, not surprisingly, associated with reduced survival. Whether this is due to the underlying myopathic process or the MR per se is not clear. Likely MR is a marker of LV dysfunction. The authors refer to the lack of proof that correction of MR improves outcomes in this subset of patients.
Well, at the last Mitral valve repair course I attended about 7 years ago, Carpentier made a special comment about this. He said that although in the past a grade II MR in the setting of CABG was left alone, there was good evidence to change his advice to “repair”. I am sure that the prolongation of operating time may worry some surgeons especially in otherwise long operations eg many grafts or redo surgery.