Impact of Mitral Valve Annuloplasty Combined With Revascularization in Patients With Functional Ischemic Mitral Regurgitation
Tomislav Mihaljevic, MD*,*,
Buu-Khanh Lam, MD*,
Jeevanantham Rajeswaran, MSc ,
Masami Takagaki, MD*,
Michael S. Lauer, MD ,
A. Marc Gillinov, MD*,a,
Eugene H. Blackstone, MD*, and
Bruce W. Lytle, MD*
* Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
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Figure 1 Survival Ater CABG Either Alone or With Concomitant MV Annuloplasty for Functional Ischemic MR
Symbols represent deaths positioned according to the Kaplan-Meier estimator, vertical bars are 68% confidence limits, and numbers in parentheses are patients still alive. Solid lines are parametric estimates enclosed within 68% confidence limits. (A) Unadjusted survival, based on 37 deaths after coronary artery bypass grafting (CABG) alone and 92 after CABG + mitral valve (MV) annuloplasty. (B) Propensity-matched survival, based on 19 deaths after CABG alone and 19 after CABG + MV annuloplasty. MR = mitral regurgitation.
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Figure 2 Proportion of Patients in MR Grades 3+ or 4+
Proportion of patients in mitral regurgitation (MR) grades 3+ or 4+ after operation. Horizontal axis is on a logarithmic scale that greatly expands times shortly after operation to better depict rapid change in the course of MR. Abbreviations as in Figure 1.
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Figure 3 Temporal Trend of NYHA Functional Classes III or IV for Propensity-Matched Patients
Solid lines represent mean effect for various functional classes. Symbols represent data grouped within time frame without regard to repeated assessment to provide a crude verification of model fit. NYHA = New York Heart Association; other abbreviations as in Figure 1.
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Figure 4 Hazard Function (Instantaneous Risk) for Death After CABG Alone or With Concomitant MV Annuloplasty
Solid lines are parametric estimates and dashed lines are their 68% confidence limits. (A) Unadjusted hazard. (B) Hazard in propensity-matched pairs. Abbreviations as in Figure 1.
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