The Annals of Thoracic Surgery, Vol 20, 529-537, Copyright © 1975 by The Society of Thoracic Surgeons
Mitral insufficiency secondary to coronary heart disease
H Najafi, H Javid, JA Hunter, MD Goldin, C Serry and WS Dye
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.
