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You are here: Contents > 2015 > Volume 24 Number 1 January 2015 > MITRAL VALVE DISEASE > Surgical Treatment of Functional Ischemic Mitral Regurgitation

Surgical Treatment of Functional Ischemic Mitral Regurgitation

Henrik Jensen1,2, Morten O. Jensen1,3, Sten L. Nielsen1

1Department of Cardiothoracic & Vascular Surgery T, Aarhus University Hospital, Aarhus, 2Institute of Clinical Medicine, University of Aarhus, Denmark, 3Georgia Institute of Technology and Emory University School of Medicine, Atlanta, GA, USA

After myocardial infarction, functional ischemic mitral regurgitation (FIMR) is present in 21% of patients, and 3-13% have at least moderate FIMR. Currently, the ‘gold-standard’ treatment of FIMR is down-sized ring annuloplasty at the time of coronary artery bypass (CABG) surgery. However, this procedure has a failure rate of 20-30% in terms of recurrent FIMR after two to four years. In many ways, a cross-roads has been reached in terms of what constitutes optimal FIMR treatment: Is CABG combined with mitral valve ring annuloplasty better than

CABG alone in moderate FIMR? Does mitral valve repair really produce better outcome than mitral valve replacement? And does adding an adjunct valvular repair or subvalvular left ventricular reverse remodelling procedure shift that balance? In order to shed further light on these questions and to help identify potential cornerstones in improving the ‘gold standard’ therapy, the present review addresses the current status and future perspectives of the surgical treatment of FIMR.

The Journal of Heart Valve Disease 2015;24:30-42

Surgical Treatment of Functional Ischemic Mitral Regurgitation

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