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Ischemic mitral insufficiency. Current state of the issue

Chernyavsky A. M., Ruzmatov T. M., Efendiev V. U., Razumakhin R. A., Nesmachny A. S., Efanova O. S., Malakhov E. S., Podsosnikova T. N., Volokitina T. L., Matveeva N. V., Prokhorova D. S.

Keywords: CAD, ischemic mitral insufficiency, coronary bypass surgery, treatment, mitral annuloplasty, surgical methods

DOI: 10.18087/rhj.2014.4.1957

Ischemic mitral insufficiency (IMI) is still one of challenging and disputable issues in the treatment of complicated IHD. Development of IMI unfavorably influences the prognosis, which depends on the severity of mitral regurgitation (MR), and increased mortality and risk for HF. At present time, the predominating concept of IMI development includes LV remodeling; imbalanced tension of valve leaflets and closure force during LV systole; LV dysfunction; changes in the spatial structure ofmitral valve annulus; and asynchrony of LV electro-mechanical activity. Echocardiography is a “gold standard” of diagnosing IMI. The most common method of IMI correction is mitral annuloplasty in combination with coronary bypass (CB). However, the rate of recurrent MR is still high (up to 30 % at 6 months post-surgery). Long-term follow-ups have also shown that the combination treatment does not provide any benefits in survival compared to isolated CB (10year survival is approximately 50 % for both methods). Therefore, multimodal approaches to the treatment of IMI are required. This article describes current options of treatment for this severe disease.
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Chernyavsky A.M., Ruzmatov T.M., Efendiev V.U. et al. Ischemic mitral insufficiency. Current state of the issue. Russian Heart Journal. 2014;78 (4):224–233

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