86 -1 (75) 2025 - Yarbekov R.R., Ismatov A.A. - PROGNOSTIC ASPECTS AND RESULTS OF SURGICAL TREATMENT OF ISCHEMIC MITRAL INSUFFICIENCY

PROGNOSTIC ASPECTS AND RESULTS OF SURGICAL TREATMENT OF ISCHEMIC MITRAL INSUFFICIENCY

Yarbekov R.R. - Bukhara State Medical Institute named after Abu Ali ibn Sina

Ismatov A.A. - Bukhara State Medical Institute named after Abu Ali ibn Sina

Teshayev U.Sh. - Bukhara State Medical Institute named after Abu Ali ibn Sina

Muradov M.M. - Bukhara State Medical Institute named after Abu Ali ibn Sina

Akhmedov X.E. - Bukhara State Medical Institute named after Abu Ali ibn Sina

Resume

An analysis of the literature shows that the views of researchers on the elimination of moderate IMN vary. On the one hand, isolated CABG has a better early prognosis due to a lower frequency of perioperative events, but it does not correct IMR. Also, many authors believe that volumetrically significant MR is a remodeling effect and that the disease is not valvular, but myocardial in origin, and, consequently, the decrease in MR did not stop or reverse the primary disease. On the other hand, the additional MK reconstruction had higher Duke Activity Status Index (DASI) scores, which indicates an improvement in physical abilities. Also, with MC intervention, there is a decrease in the frequency of recurrent significant MR and a potential improvement in the NYHA class.

Key words: Mitral regurgitation, aorta coronary bypass (CABG), heart failure, left ventricle, mitral valve repair, mitral valve, prosthetic replacement, complications.

First page

499

Last page

505

For citation:Yarbekov R.R., Ismatov A.A., Teshayev U.Sh., Muradov M.M., Akhmedov X.E. - PROGNOSTIC ASPECTS AND RESULTS OF SURGICAL TREATMENT OF ISCHEMIC MITRAL INSUFFICIENCY//New Day in Medicine 1(75)2025 499-505 https://https://newdayworldmedicine.com/en/new_day_medicine/1-75-2025

List of References

  1. Roshanali F, Mandegar MH, Yousefnia MA, Alaeddini F, Wann S. Low-dose dobutamine stress echocardiography to predict reversibility of mitral regurgitation with CABG. //Echocardiography. 2006 Jan;23(1):31-7. doi: 10.1111/j.1540-8175.2006.00163.x. PMID: 16412180.
  2. Penicka M, Linkova H, Lang O, Fojt R, Kocka V, Vanderheyden M, Bartunek J. Predictors of improvement of unrepaired moderate ischemic mitral regurgitation in patients undergoing elective isolated coronary artery bypass graft surgery. //Circulation. 2009 Oct 13;120(15):1474-81. doi: 10.1161/CIRCULATIONAHA.108.842104. Epub 2009 Sep 28. PMID: 19786637.
  3. Fattouch K, Guccione F, Sampognaro R, Panzarella G, Corrado E, Navarra E, Calvaruso D, Ruvolo G. 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 Aug;138(2):278-85. doi: 10.1016/j.jtcvs.2008.11.010. Epub 2009 May 31. PMID: 19619766.
  4. Chan KM, Punjabi PP, Flather M, Wage R, Symmonds K, Roussin I, Rahman-Haley S, Pennell DJ, Kilner PJ, Dreyfus GD, Pepper JR; RIME Investigators. 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 Nov 20;126(21):2502-10. doi: 10.1161/CIRCULATIONAHA.112.143818. Epub 2012 Nov 7. PMID: 23136163.
  5. Michler RE, Smith PK, Parides MK, et al.; CTSN. Two-Year Outcomes of Surgical Treatment of Moderate Ischemic Mitral Regurgitation. //N Engl J Med. 2016 May 19;374(20):1932-41. doi: 10.1056/NEJMoa1602003. Epub 2016 Apr 3. PMID: 27040451; PMCID: PMC4908820.
  6. Bouchard D, Jensen H, Carrier M, Demers P, Pellerin M, Perrault LP, Lambert J. Effect of systematic downsizing rigid ring annuloplasty in patients with moderate ischemic mitral regurgitation. //J Thorac Cardiovasc Surg. 2014 May;147(5):1471-7. doi: 10.1016/j.jtcvs.2013.05.024. Epub 2013 Jul 13. PMID: 23856201.
  7. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. //J Am Coll Cardiol. 2017 Jul 11;70(2):252-289. doi: 10.1016/j.jacc.2017.03.011. Epub 2017 Mar 15. PMID: 28315732.
  8. Rossi A, Dini FL, Faggiano P, Agricola E, Cicoira M, Frattini S, Simioniuc A, Gullace M, Ghio S, Enriquez-Sarano M, Temporelli PL. Independent prognostic value of functional mitral regurgitation in patients with heart failure. A quantitative analysis of 1256 patients with ischaemic and non-ischaemic dilated cardiomyopathy. //Heart. 2011 Oct;97(20):1675-80. doi: 10.1136/hrt.2011.225789. Epub 2011 Jul 31. PMID: 21807656.
  9. Anantha Narayanan M, Aggarwal S, Reddy YNV, Alla VM, Baskaran J, Kanmanthareddy A, Suri RM. Surgical Repair of Moderate Ischemic Mitral Regurgitation-A Systematic Review and Meta-analysis. //Thorac Cardiovasc Surg. 2017 Sep;65(6):447-456. doi: 10.1055/s-0036-1598012. Epub 2017 Jan 21. PMID: 28109210.
  10. Grayburn PA, Sannino A, Packer M. Proportionate and Disproportionate Functional Mitral Regurgitation: A New Conceptual Framework That Reconciles the Results of the MITRA-FR and COAPT Trials. //JACC Cardiovasc Imaging. 2019 Feb;12(2):353-362. doi: 10.1016/j.jcmg.2018.11.006. Epub 2018 Dec 12. PMID: 30553663.
  11. Pibarot P, Delgado V, Bax JJ. MITRA-FR vs. COAPT: lessons from two trials with diametrically opposed results. //Eur Heart J Cardiovasc Imaging. 2019 Jun 1;20(6):620-624. doi: 10.1093/ehjci/jez073. PMID: 31115470; PMCID: PMC6529908.
  12. Winkler A, Jaguś-Jamioła A, Uziębło-Życzkowska B, et al. Predictors of appropriate interventions and mortality in patients with implantable cardioverter-defibrillators. //Pol Arch Intern Med. 2019; 129: 667-672. doi:10.20452/pamw.14967
  13. Trohman RG. Predicting appropriate therapies and mortality in implantable cardioverter-defibrillator recipients: a work in progress. //Pol Arch Intern Med. 2019;129:657-658. doi:10.20452/pamw.15038
  14. Mihaljevic T, Lam BK, Rajeswaran J, Takagaki M, Lauer MS, Gillinov AM, Blackstone EH, Lytle BW. Impact of mitral valve annuloplasty combined with revascularization in patients with functional ischemic mitral regurgitation. //J Am Coll Cardiol. 2007 Jun 5;49(22):2191-201. doi: 10.1016/j.jacc.2007.02.043. Epub 2007 May 18. PMID: 17543639.
  15. Smith PK, Puskas JD, Ascheim DD, et al. Cardiothoracic Surgical Trials Network Investigators. Surgical treatment of moderate ischemic mitral regurgitation. //N Engl J Med. 2014 Dec 4;371(23):2178-88. doi: 10.1056/NEJMoa1410490. Epub 2014 Nov 18. PMID: 25405390; PMCID: PMC4303577.
  16. Шихвердиев Н.Н., Марченко С.П. Основы реконструктивной хирургии клапанов сердца / Под общ. ред. Н.Н. Шихвердиева. СПб.: Дитон; 2007.
  17. Карева Ю.Е., Эфендиев В.У., Рахмонов Сардор Собирович, Чернявский А.М., Лукинов В.Л. Факторы риска возврата митральной недостаточности после аортокоронарного шунтирования и реконструкции митрального клапана у пациентов с ишемической кардиомиопатией //ПКиК. 2019; 2.
  18. Волков А.М., Пайвин А.А., Иванов Г.М., Иващенко А.И., Павлов А.В., Алексанян М.Г., Хубулава Г.Г. (2013). Особенности хирургического лечения умеренной ишемической митральной недостаточности у пациентов «Высокого риска». //Вестник хирургии имени И. И. Грекова, 2013;172(4):11-16.
  19. Feldman T, Foster E, Glower DD, et al. EVEREST II Investigators. Percutaneous repair or surgery for mitral regurgitation. //N Engl J Med. 2011 Apr 14;364(15):1395-406. doi: 10.1056/NEJMoa1009355. Epub 2011 Apr 4. Erratum in: N Engl J Med. 2011 Jul 14;365(2):189. Glower, Donald G [corrected to Glower, Donald D]. PMID:
  20. Ailawadi G., Lim DS., Mack MJ., Trento A., Kar S. EVEREST II Investigators. One-Year Outcomes After MitraClip for Functional Mitral Regurgitation. //Circulation. 2019 Jan 2;139(1):37-47. doi: 10.1161/Circulationaha.117.031733. PMID: 30586701.

    file

    download