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Hassan Najafi
Hushang Javid
James A. Hunter
Cyrus Serry
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Ann Thorac Surg 1975;20:529-537
© 1975 The Society of Thoracic Surgeons

Articles

Mitral Insufficiency Secondary to Coronary Heart Disease

Hassan Najafi, M.D.*, Hushang Javid, M.D., James A. Hunter, M.D., Marshall D. Goldin, M.D., Cyrus Serry, M.D., William S. Dye, M.D.

Department of Cardiovascular-Thoracic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Ill.

* Address reprint requests to Dr. Najafi, Suite 850, 1725 W. Harrison St., Chicago, Ill. 60612

Twenty-four patients were operated on for mitral regurgitation secondary to coronary heart disease. Their common features consisted of a history of myocardial infarction, congestive heart failure, coronary occlusive disease, left ventricular dysfunction, low cardiac output, pulmonary hypertension, and increased left ventricular end-diastolic pressure. Fourteen patients were in intractable congestive heart failure at the time of operation.

The operative procedures employed consisted of aneurysmectomy in 4 patients; mitral valve replacement (MVR) in 7; MVR and revascularization in 4; MVR and aneurysmectomy in 5; MVR, revascularization, and partial ventricular resection in 3; and MVR with closure of ventricular septal perforation in 1 patient. Six patients died, a hospital mortality of 25%, and only 42% had good results. The degree of associated coronary artery disease and the status of the left ventricular myocardium were the most important prognostic factors.




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