Analysis about surgical management of moderate ischemic mitral valve regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YU Chunyu ,  ZHENG Zhe

Department of Cardiovascular Surgery, Fuwai Hospital, Beijing Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China;

Corresponding author：

ZHENG Zhe, Email: zhengzhe@fuwai.com

Keywords：

Ischemic mitral regurgitation; coronary heart disease; coronary artery bypass grafting; mitral valve surgery

DOI：

10.7507/1007-4848.201811064

Video：

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Ischemic mitral regurgitation represents a common complication after myocardial infarction, the severity of the mitral regurgitation increases the risk of mortality. There is continuing debate regarding the management of moderate ischemic mitral regurgitation in patients undergoing surgical management. The debates lie in whether adding mitral valve surgery to coronary artery bypass grafting. So the review is about the analysis of existing evidence and expectation about it.

Citation： YU Chunyu, ZHENG Zhe. Analysis about surgical management of moderate ischemic mitral valve regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(7): 723-727. doi: 10.7507/1007-4848.201811064 Copy

1.	刘星, 饶莉. 缺血性二尖瓣反流的发病机制及其诊疗进展. 临床内科杂志, 2008, 6(25): 430-432.
2.	Hickey MS, Smith LR, Muhlbaier LH, et al. Current prognosis of ischemic mitral regurgitation. Implications for future management. Circulation, 1988, 78(3 Pt 2): I51-59.
3.	Bursi F, Enriquez-Sarano M, Nkomo VT, et al. Heart failure and death after myocardial infarction in the community: the emerging role of mitral regurgitation. Circulation, 2005, 111(3): 295-301.
4.	Grigioni F, Enriquez-Sarano M, Zehr KJ, et al. Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation, 2001, 103(13): 1759-1764.
5.	Fattouch K, Sampognaro R, Speziale G, et al. Impact of moderate ischemic mitral regurgitation after isolated coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(4): 1187-1194.
6.	Kwon MH, Cevasco M, Chen FY. Functional, ischemic mitral regurgitation: to repair or not to repair? Circulation, 2012, 125(21): 2563-2565.
7.	Di Salvo TG, Acker MA, Dec GW, et al. Mitral valve surgery in advanced heart failure. J Am Coll Cardiol, 2010, 55(4): 271-282.
8.	Deja MA, Grayburn PA, Sun B, et al. Influence of mitral regurgitation repair on survival in the surgical treatment for ischemic heart failure trial. Circulation, 2012, 125(21): 2639-2648.
9.	Bax JJ, Braun J, Somer ST, et al. Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling. Circulation, 2004, 110(11 Suppl 1): Ⅱ103-Ⅱ108.
10.	Trento A, Goland S, De Robertis MA, et al. COUNTERPOINT: Efficacy of adding mitral valve restrictive annuloplasty to coronary artery bypass grafting in patients with moderate ischemic mitral valve regurgitation. J Thorac Cardiovasc Surg, 2009, 138(2): 286-288.
11.	王东旭, 张永, 王辉山. 缺血性二尖瓣反流外科治疗现状. 临床军医杂志, 2017, 7(45): 761-764.
12.	Dal-Bianco JP, Beaudoin J, Handschumacher MD, et al. Basic mechanisms of mitral regurgitation. Can J Cardiol, 2014, 30(9): 971-981.
13.	Benfari G, Dandale R, Rossi A, et al. Functional mitral regurgitation: are we treating the real target? J Cardiovasc Med (Hagerstown), 2016, 17(11): 767-773.
14.	Bouma W, van der Horst IC, Wijdh-den Hamer IJ, et al. Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches. Eur J Cardiothorac Surg, 2010, 37(1): 170-185.
15.	Yiu SF, Enriquez-Sarano M, Tribouilloy C, et al. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction: A quantitative clinical study. Circulation, 2000, 102(12): 1400-1406.
16.	Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr, 2003, 16(7): 777-802.
17.	Lancellotti P, Moura L, Pierard LA, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr, 2010, 11(4): 307-332.
18.	O'Gara PT. Randomized trials in moderate ischemic mitral regurgitation: many questions, limited answers. Circulation, 2012, 126(21): 2452-2455.
19.	Ryan L, Jackson B, Parish L, et al. Quantification and localization of mitral valve tenting in ischemic mitral regurgitation using real-time three-dimensional echocardiography. Eur J Cardiothorac Surg, 2007, 31(5): 834-839.
20.	Krishnaswamy A, Marc Gillinov A, Griffin BP. Ischemic mitral regurgitation: pathophysiology, diagnosis, and treatment. Coron Artery Dis, 2011, 22(5): 359-370.
21.	Salehi M, Bakhshandeh A, Rahmanian M, et al. Coronary artery bypass grafting in patients with advanced left ventricular dysfunction: excellent early outcome with improved ejection fraction. J Tehran Heart Cent, 2016, 11(1): 6-10.
22.	Zhang H, Liu Y, Qiu S, et al. Short-term and long-term survival after revascularization with or without mitral valve surgery of patients with ischemic mitral valve regurgitation: a meta-analysis. Med Sci Monit, 2015, 21: 3784-3791.
23.	Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J, 2019, 55(1): 4-90.
24.	Aklog L, Filsoufi F, Flores KQ, et al. Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation? Circulation, 2001, 104(12 Suppl 1): I68-I75.
25.	Harris KM, Sundt TM, 3 rd, Aeppli D, et al. Can late survival of patients with moderate ischemic mitral regurgitation be impacted by intervention on the valve? Ann Thorac Surg, 2002, 74(5): 1468-1475.
26.	Trichon BH, Glower DD, Shaw LK, et al. Survival after coronary revascularization, with and without mitral valve surgery, in patients with ischemic mitral regurgitation. Circulation, 2003, 108(Suppl 1): II103-110.
27.	Diodato MD, Moon MR, Pasque MK, et al. Repair of ischemic mitral regurgitation does not increase mortality or improve long-term survival in patients undergoing coronary artery revascularization: a propensity analysis. Ann Thorac Surg, 2004, 78(3): 794-799.
28.	Kim YH, Czer LS, Soukiasian HJ, et al. Ischemic mitral regurgitation: revascularization alone versus revascularization and mitral valve repair. Ann Thorac Surg, 2005, 79(6): 1895-1901.
29.	Wong DR, Agnihotri AK, Hung JW, et al. Long-term survival after surgical revascularization for moderate ischemic mitral regurgitation. Ann Thorac Surg, 2005, 80(2): 570-577.
30.	Bonacchi M, Prifti E, Maiani M, et al. Mitral valve surgery simultaneous to coronary revascularization in patients with end-stage ischemic cardiomyopathy. Heart Vessels, 2006, 21(1): 20-27.
31.	Kang DH, Kim MJ, Kang SJ, et al. Mitral valve repair versus revascularization alone in the treatment of ischemic mitral regurgitation. Circulation, 2006, 114(1 Suppl): I499-503.
32.	Buja P, Tarantini G, Del Bianco F, et al. Moderate-to-severe ischemic mitral regurgitation and multivessel coronary artery disease: Impact of different treatment on survival and rehospitalization. Int J Cardiol, 2006, 111(1): 26-33.
33.	Mihaljevic T, Lam BK, Rajeswaran J, et al. Impact of mitral valve annuloplasty combined with revascularization in patients with functional ischemic mitral regurgitation. J Am Coll Cardiol, 2007, 49(22): 2191-2201.
34.	Goland S, Czer LS, Siegel RJ, et al. Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral regurgitation. Tex Heart Inst J, 2009, 36(5): 416-424.
35.	Benedetto U, Melina G, Roscitano A, et al. Does combined mitral valve surgery improve survival when compared to revascularization alone in patients with ischemic mitral regurgitation? A meta-analysis on 2479 patients. J Cardiovasc Med (Hagerstown), 2009, 10(2): 109-114.
36.	Fattouch K, Guccione F, Sampognaro R, et al. Point: Efficacy of adding mitral valve restrictive annuloplasty to coronary artery bypass grafting in patients with moderate ischemic mitral valve regurgitation: a randomized trial. J Thorac Cardiovasc Surg, 2009, 138(2): 278-285.
37.	Joint Task Force on the Management of Valvular Heart Disease of the European Society of C, European Association for Cardio-Thoracic S, Vahanian A, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
38.	Chan KM, Punjabi PP, Flather M, et al. Coronary artery bypass surgery with or without mitral valve annuloplasty in moderate functional ischemic mitral regurgitation: final results of the Randomized Ischemic Mitral Evaluation (RIME) trial. Circulation, 2012, 126(21): 2502-2510.
39.	Bouchard D, Jensen H, Carrier M, et al. Effect of systematic downsizing rigid ring annuloplasty in patients with moderate ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2014, 147(5): 1471-1477.
40.	Authors/Task Force m, Windecker S, Kolh P, et al. 2014 ESC/EACTS guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J, 2014, 35(37): 2541-2619.
41.	Smith PK, Michler RE, Woo YJ, et al. Design, rationale, and initiation of the surgical interventions for moderate ischemic mitral regurgitation trial: a report from the Cardiothoracic Surgical Trials Network. J Thorac Cardiovasc Surg, 2012, 143(1): 111-117.
42.	Smith PK, Puskas JD, Ascheim DD, et al. Surgical treatment of moderate ischemic mitral regurgitation. N Engl J Med, Dec 4 2014, 371(23): 2178-2188.
43.	Michler RE, Smith PK, Parides MK, et al. Two-year outcomes of surgical treatment of moderate ischemic mitral regurgitation. N Engl J Med, 2016, 374(20): 1932-1941.

1. 刘星, 饶莉. 缺血性二尖瓣反流的发病机制及其诊疗进展. 临床内科杂志, 2008, 6(25): 430-432.
2. Hickey MS, Smith LR, Muhlbaier LH, et al. Current prognosis of ischemic mitral regurgitation. Implications for future management. Circulation, 1988, 78(3 Pt 2): I51-59.
3. Bursi F, Enriquez-Sarano M, Nkomo VT, et al. Heart failure and death after myocardial infarction in the community: the emerging role of mitral regurgitation. Circulation, 2005, 111(3): 295-301.
4. Grigioni F, Enriquez-Sarano M, Zehr KJ, et al. Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation, 2001, 103(13): 1759-1764.
5. Fattouch K, Sampognaro R, Speziale G, et al. Impact of moderate ischemic mitral regurgitation after isolated coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(4): 1187-1194.
6. Kwon MH, Cevasco M, Chen FY. Functional, ischemic mitral regurgitation: to repair or not to repair? Circulation, 2012, 125(21): 2563-2565.
7. Di Salvo TG, Acker MA, Dec GW, et al. Mitral valve surgery in advanced heart failure. J Am Coll Cardiol, 2010, 55(4): 271-282.
8. Deja MA, Grayburn PA, Sun B, et al. Influence of mitral regurgitation repair on survival in the surgical treatment for ischemic heart failure trial. Circulation, 2012, 125(21): 2639-2648.
9. Bax JJ, Braun J, Somer ST, et al. Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling. Circulation, 2004, 110(11 Suppl 1): Ⅱ103-Ⅱ108.
10. Trento A, Goland S, De Robertis MA, et al. COUNTERPOINT: Efficacy of adding mitral valve restrictive annuloplasty to coronary artery bypass grafting in patients with moderate ischemic mitral valve regurgitation. J Thorac Cardiovasc Surg, 2009, 138(2): 286-288.
11. 王东旭, 张永, 王辉山. 缺血性二尖瓣反流外科治疗现状. 临床军医杂志, 2017, 7(45): 761-764.
12. Dal-Bianco JP, Beaudoin J, Handschumacher MD, et al. Basic mechanisms of mitral regurgitation. Can J Cardiol, 2014, 30(9): 971-981.
13. Benfari G, Dandale R, Rossi A, et al. Functional mitral regurgitation: are we treating the real target? J Cardiovasc Med (Hagerstown), 2016, 17(11): 767-773.
14. Bouma W, van der Horst IC, Wijdh-den Hamer IJ, et al. Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches. Eur J Cardiothorac Surg, 2010, 37(1): 170-185.
15. Yiu SF, Enriquez-Sarano M, Tribouilloy C, et al. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction: A quantitative clinical study. Circulation, 2000, 102(12): 1400-1406.
16. Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr, 2003, 16(7): 777-802.
17. Lancellotti P, Moura L, Pierard LA, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr, 2010, 11(4): 307-332.
18. O'Gara PT. Randomized trials in moderate ischemic mitral regurgitation: many questions, limited answers. Circulation, 2012, 126(21): 2452-2455.
19. Ryan L, Jackson B, Parish L, et al. Quantification and localization of mitral valve tenting in ischemic mitral regurgitation using real-time three-dimensional echocardiography. Eur J Cardiothorac Surg, 2007, 31(5): 834-839.
20. Krishnaswamy A, Marc Gillinov A, Griffin BP. Ischemic mitral regurgitation: pathophysiology, diagnosis, and treatment. Coron Artery Dis, 2011, 22(5): 359-370.
21. Salehi M, Bakhshandeh A, Rahmanian M, et al. Coronary artery bypass grafting in patients with advanced left ventricular dysfunction: excellent early outcome with improved ejection fraction. J Tehran Heart Cent, 2016, 11(1): 6-10.
22. Zhang H, Liu Y, Qiu S, et al. Short-term and long-term survival after revascularization with or without mitral valve surgery of patients with ischemic mitral valve regurgitation: a meta-analysis. Med Sci Monit, 2015, 21: 3784-3791.
23. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J, 2019, 55(1): 4-90.
24. Aklog L, Filsoufi F, Flores KQ, et al. Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation? Circulation, 2001, 104(12 Suppl 1): I68-I75.
25. Harris KM, Sundt TM, 3 rd, Aeppli D, et al. Can late survival of patients with moderate ischemic mitral regurgitation be impacted by intervention on the valve? Ann Thorac Surg, 2002, 74(5): 1468-1475.
26. Trichon BH, Glower DD, Shaw LK, et al. Survival after coronary revascularization, with and without mitral valve surgery, in patients with ischemic mitral regurgitation. Circulation, 2003, 108(Suppl 1): II103-110.
27. Diodato MD, Moon MR, Pasque MK, et al. Repair of ischemic mitral regurgitation does not increase mortality or improve long-term survival in patients undergoing coronary artery revascularization: a propensity analysis. Ann Thorac Surg, 2004, 78(3): 794-799.
28. Kim YH, Czer LS, Soukiasian HJ, et al. Ischemic mitral regurgitation: revascularization alone versus revascularization and mitral valve repair. Ann Thorac Surg, 2005, 79(6): 1895-1901.
29. Wong DR, Agnihotri AK, Hung JW, et al. Long-term survival after surgical revascularization for moderate ischemic mitral regurgitation. Ann Thorac Surg, 2005, 80(2): 570-577.
30. Bonacchi M, Prifti E, Maiani M, et al. Mitral valve surgery simultaneous to coronary revascularization in patients with end-stage ischemic cardiomyopathy. Heart Vessels, 2006, 21(1): 20-27.
31. Kang DH, Kim MJ, Kang SJ, et al. Mitral valve repair versus revascularization alone in the treatment of ischemic mitral regurgitation. Circulation, 2006, 114(1 Suppl): I499-503.
32. Buja P, Tarantini G, Del Bianco F, et al. Moderate-to-severe ischemic mitral regurgitation and multivessel coronary artery disease: Impact of different treatment on survival and rehospitalization. Int J Cardiol, 2006, 111(1): 26-33.
33. Mihaljevic T, Lam BK, Rajeswaran J, et al. Impact of mitral valve annuloplasty combined with revascularization in patients with functional ischemic mitral regurgitation. J Am Coll Cardiol, 2007, 49(22): 2191-2201.
34. Goland S, Czer LS, Siegel RJ, et al. Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral regurgitation. Tex Heart Inst J, 2009, 36(5): 416-424.
35. Benedetto U, Melina G, Roscitano A, et al. Does combined mitral valve surgery improve survival when compared to revascularization alone in patients with ischemic mitral regurgitation? A meta-analysis on 2479 patients. J Cardiovasc Med (Hagerstown), 2009, 10(2): 109-114.
36. Fattouch K, Guccione F, Sampognaro R, et al. Point: Efficacy of adding mitral valve restrictive annuloplasty to coronary artery bypass grafting in patients with moderate ischemic mitral valve regurgitation: a randomized trial. J Thorac Cardiovasc Surg, 2009, 138(2): 278-285.
37. Joint Task Force on the Management of Valvular Heart Disease of the European Society of C, European Association for Cardio-Thoracic S, Vahanian A, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
38. Chan KM, Punjabi PP, Flather M, et al. Coronary artery bypass surgery with or without mitral valve annuloplasty in moderate functional ischemic mitral regurgitation: final results of the Randomized Ischemic Mitral Evaluation (RIME) trial. Circulation, 2012, 126(21): 2502-2510.
39. Bouchard D, Jensen H, Carrier M, et al. Effect of systematic downsizing rigid ring annuloplasty in patients with moderate ischemic mitral regurgitation. J Thorac Cardiovasc Surg, 2014, 147(5): 1471-1477.
40. Authors/Task Force m, Windecker S, Kolh P, et al. 2014 ESC/EACTS guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J, 2014, 35(37): 2541-2619.
41. Smith PK, Michler RE, Woo YJ, et al. Design, rationale, and initiation of the surgical interventions for moderate ischemic mitral regurgitation trial: a report from the Cardiothoracic Surgical Trials Network. J Thorac Cardiovasc Surg, 2012, 143(1): 111-117.
42. Smith PK, Puskas JD, Ascheim DD, et al. Surgical treatment of moderate ischemic mitral regurgitation. N Engl J Med, Dec 4 2014, 371(23): 2178-2188.
43. Michler RE, Smith PK, Parides MK, et al. Two-year outcomes of surgical treatment of moderate ischemic mitral regurgitation. N Engl J Med, 2016, 374(20): 1932-1941.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis about surgical management of moderate ischemic mitral valve regurgitation

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