Surgical Approach to Ischemic Mitral Regurgitation Following the First
Acute Myocardial Infarction
Abstract
Background: Ischemic mitral valve regurgitation is a subgroup
of secondary mitral valve insufficiency that develops due to ischemic
heart disease. The aim of the study is to evaluate the patients who were
operated after acute myocardial infarction for the type of interventions
to be performed for the mitral valve in terms of mortality and
morbidity. Methods: It is a single-centered, retrospective
study. Patients who were admitted to the hospital with the diagnosis of
acute myocardial infarction and operated emergently or urgently between
January 2017 and December 2020 were evaluated. Patients who were found
to have significant IMR (≥ moderate mitral regurgitation) in the early
period and who could achieve complete revascularization were included in
the study. Patients were divided into two groups whether the mitral
valve was intervened or not. Results: The demographical data of
the patients that were included in the study is as follows, 73.4% were
male and 33% were female. The average age of the patients was 63.2 ±
8.9. Patients were compared in terms of significant (moderate or higher)
postoperative residual mitral regurgitation. 62.2% (n=23) of the
patients undergone isolated CABG had mild mitral regurgitation. 5
patients with mitral valve annuloplasty (17.9%) had significant
residual regurgitation (p<0.001). Conlusion: Mitral
valve intervention should not be considered in non-severe mitral valve
insufficiencies (without papillary rupture or chorda rupture) after
acute MI. Preservation of the dynamic structure of the mitral valve
annulus in the acute period makes mitral ring annuloplasty not an
appropriate treatment.