Chronic ischemic mitral regurgitation (IMR) is a prevalent problem among patients following a myocardial infarction. Until recently, the pathophysiology was poorly understood, resulting in surgical strategies with suboptimal results and limited durability. The presence of mild to moderate ischemic mitral regurgitation results in significantly reduced long-term survival and increased hospitalizations for heart-failure.
The surgical approach for ischemic mitral regurgitation repair has evolved from revascularization alone to an additional procedure, mitral valve repair or replacement. In this type of surgery, the treatment essentially involves implantation of an artificial ring (annuloplasty ring) along with coronary artery bypass grafting (CABG). The benefit of adding mitral valve surgery to coronary artery bypass surgery (CABG) is well documented in patients with coronary artery disease and severe mitral regurgitation.
Coronary artery bypass grafting (CABG) is a type of surgery called revascularization, used to improve blood flow to the heart in patients with severe coronary artery disease (CAD). CAD occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become blocked due to buildup of plaque on the inside of the blood vessels. During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (goes around) the blocked portion of the coronary artery. This new passage routes oxygen-rich blood around the blockage to the heart muscle. A bypass typically requires open-chest surgery and the use of a heart-lung bypass machine to circulate the blood and add oxygen.
