LEFT VENTRICULAR REMODELLING AND MITRAL VALVE REMODELLING IN CORONARY HEART DISEASE PATIENTS WITH POST-SURGERY PROGRESSION OF MITRAL REGURGITATION

Abstract

The progression of ischemic mitral regurgitation (MR) after coronary arty bypass graft (CABG) surgery remains one of the most complex and still unresolved problems in the treatment of coronary heart disease (CHD).Aim. To study myocardial function, left ventricular (LV) remodelling, and mitral valve (MV) remodelling in CHD patients with MR progression after isolated CABG or CABG combined with LV reconstructive surgery.Material and methods. In total, 101 CHD patients after CABG were included in the analysis.Results. The mechanisms of MR progression after isolated CABG differ from those after CABG and LV reconstructive surgery. After the former, LV remodelling progresses both locally and globally, while after the latter, the LV remodelling progression is predominantly global. The patients with post-surgery MR progression differ from their peers without MR in terms of all key parameters of MV geometry.Conclusion. The leading mechanism of MR progression is local and global LV remodelling, which leads to papillary muscle dislocation and MV leaflet tension and restricted motion. The categories of patients with a high risk of post-surgery MR progression are defined.

Keywords

• ischemic mitral regurgitation
• progressing mitral insufficiency
• coronary artery bypass graft surgery
• left ventricular reconstructive surgery