AbstractObjective: To evaluate outcome following On pump Coronary artery bypass grafting for Coronary artery disease without addressing associated Chronic ischemic mitral regurgitation. To find out the efficacy and adequacy of On pump Coronary artery bypass grafting and factors affecting the outcome in these patients.
Methods: This study was conducted in 30 patients of CAD with trace, mild or moderate MR and treated with coronary artery bypass grafting from January 2012 to December 2012. Group I (n=19) included patients of CAD associated with trivial (1+) or mild (2+) ischemic MR and Group II (n=11) included patients of CAD associated with moderate (3+) ischemic MR. Pre and postoperative data related to clinical profile, ECG, 2D Echocardiography along with preoperative CAG and LV angiogram data, collected. All patients underwent conventional on pump CABG.
Patients were followed up at 2 and 6 months after surgery.
Results: There was similar downgrade of congestive heart failure NYHA class, in both the groups. In Group I, there was significant improvement in echocardiographic parameters like LVEDD, LVEF, LVESD, EPSS and
ESV. In Group II, there was significant improvement in echocardiographic parameters like LVEDD, LVEF, EPSS and ESV. Postoperative echo revealed downgrading of MR. Mean MR of Group I downgraded from 1.8 to 1.4, postoperatively. Mean MR of Group II downgraded from 3.0 to 2.6, postoperatively. There was no incidence of readmission due to congestive heart failure or mortality in either of the groups.
Conclusion: Revascularization alone for trivial to moderate ischemic MR achieves low operative mortality, leads to EF improvement, decreases MR and improves NYHA class but longer follow up could shed more light on long term outcomes and survival benefit.