Outcome after Mitral Valve Repair for Functional Ischemic Mitral Regurgitation
Stephen A. Tahta MD, James H. Oury MD, J. Matt Maxwell MD, Stephen P. Hiro MD, Carlos M.G. Duran MD

Functional ischemic mitral regurgitation remains controversial. Herein, the results are presented of coronary artery bypass with mitral valve repair. A total of 100 consecutive patients with moderate mitral regurgitation or worse underwent surgery. NYHA functional class was III-IV in 72%. Early mortality was 12%, and late mortality 14%. Three-year survival was 77%. Follow up NYHA class was I-II in 81%. Despite immediate postoperative mitral regurgitation grades of 0-1+ in 98% of patients, 29% of late survivors returned in follow up with recurrent mitral insufficiency of grade ›2+. The parameters examined that were predictive of recurrent mitral insufficiency were presence of preoperative myocardial infarction and left ventricular dysfunction on follow up only. Our current clinical decision-making algorithm for functional ischemic mitral regurgitation is outlined.