Volume 72 Number 2 March 2005	back to contents

From the Department of Cardiothoracic Surgery, Mount Sinai Medical Center , New York , NY.

Address all correspondence to Farzan Filsoufi, M.D., Director Cardiac Valve Center and Assistant Professor, Department of Cardiothoracic Surgery, Box 1028, Mount Sinai Medical Center, 1 East 100 th Street, New York, NY 10029; email: Farzan.Filsoufi@mountsinai.org

Adapted from a Grand Rounds presentation to the Department of Medicine, Mount Sinai School of Medicine, New York, NY on April 15, 2002, and updated as of September 2004.

ABSTRACT

Severe coronary artery disease and myocardial infarction can be complicated by ischemic mitral regurgitation (IMR). IMR results from left ventricular remodeling after myocardial infarction and in rare instances can accompany acute ischemia. A better understanding of the pathophysiology of IMR and increased awareness of its negative impact on long-term survival explain the recent rise in the number of patients referred for surgical correction of IMR at the time of coronary revascularization. The most common mechanism of IMR is Carpentier’s type IIIb dysfunction, for which an undersized remodeling annuloplasty is the treatment of choice. In this article we define ischemic mitral regurgitation and review its pathophysiology, clinical presentations, diagnosis, indication for surgery, and management.

KEYWORDS

Mitral regurgitation, ischemic cardiomyopathy, coronary artery disease, mitral valve surgery, coronary artery bypass grafting.

MSSM Home

Back Issues | Indexes | Search | Journal Home