Ischemic mitral regurgitation: modern possibilities of diagnostic and surgical treatment

Revishvili G.A., Zhbanov I.V., Shabalkin B.V.

Coronary heart disease (CHD) is still one of the most common causes of disability in developed countries. One of these complications is ischemic mitral regurgitation (IMR) — a formidable disease associated with primary ischemic damage of the myocardium of the left ventricle (LV). According to various authors, the 5-year survival rate in patients with IMR does not reach 70%. The leading problem in the treatment of this pathology is the assessment of the severity of the insufficiency, the mechanisms of its formation and the choice of an individually selected surgical strategy. Despite the many studies and definitions of tactics in relation to severe IMR, the management of patients with minor and moderate IMR is still a controversial issue. According to a number of authors, hospital mortality in the combined treatment of coronary arteries (CA) and mitral valve (MV) can reach 17%, however, isolated coronary artery bypass grafting (CABG) does not improve valve closure function. This review analyzes the mechanisms of the formation of medical conditions, the main diagnostic methods and various tactics of surgical treatment.

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