The immediate results of surgical correction of ischemic mitral insufficiency using suture annuloplasty in patients with reduced left ventricular ejection fraction

The main goal of our research was to assess results of the suture annuloplasty for treatment of ischemic mitral regurgitation. We have analyzed the medical records of 37 patients with ischemic heart disease complicated by mitral regurgitation with impaired systolic function of left ventricle (ejection fraction 40% or less). We have made combined open heart surgery in all patients: coronary bypass graphting with suture mitral valve annuloplasty. All patients had serious heart failure with moderate to high pulmonary hypertension. The main principle of this method is a reduction of mitral valve fibrous annulus diameter and turn off tethering and return normal leaflets coaptation. There was no in-hospital mortality. All patients had regress of pressure in pulmonary artery after reduction of mitral insufficiency. 8 patients have returned mitral regurgitation. 1 patient has required mitral prosthesis because of serious mitral regurgitation. We have analyzed all cases of returning of mitral regurgitation and have found some causes. We have seen real improving in clinical status of patients in follow-up. The suture mitral annuloplasty is an effective method of surgical correction of ischemic mitral regurgitation. It improves reverse left ventricular remodeling. Clinically relevant mitral stenosis was not detected. It tends to better clinical prognosis of chronic heart failure. In the late period, four patients died.