Balu V, Hershowitz S, Zaki Masud A R, Bhayana J N, Dean D C
Chest. 1982 May;81(5):550-5. doi: 10.1378/chest.81.5.550.
Over a period of 5.25 years, 1,530 patients with coronary artery disease (CAD) underwent catheterization; 104 had associated mitral regurgitation (MR), and 60 had no complications. Twelve patients underwent coronary artery bypass graft surgery (CABG), with both pre- and postoperative angiograms. Nine of the 12 patients (75 percent) were in functional class 3 or 4. Left ventricular ejection fraction ranged from 34 to 75. The MR was considered severe (3+) in three, moderate (2+) in six, and trivial (1+) in three patients. Following CABG, all except two patients were in class 1. Of the 43 patients medically treated, 31 patients (72 percent) were in functional class 3 or 4. Angiographic results showed that five patients had 3+ MR, 14 had 2+ MR, and 24 had 1+ MR. The EF was less than 30 in 23 patients and greater than or equal to 30 in 20 patients, and left ventricular filling pressure was elevated. Twenty patients died, with a mean follow-up period of 11 months. Our study demonstrates that the surgically treated patients showed angiographic improvement in MR, improved functional status, and relief of symptoms compared with medically treated patients. We believe that a subset of patients with MR and CAD would benefit with CABG.
在5.25年的时间里，1530例冠心病（CAD）患者接受了导管插入术；104例伴有二尖瓣反流（MR），60例无并发症。12例患者接受了冠状动脉旁路移植术（CABG），术前行血管造影，术后也进行了血管造影。12例患者中有9例（75%）心功能分级为3级或4级。左心室射血分数在34%至75%之间。3例患者的MR被认为是重度（3+），6例为中度（2+），3例为轻度（1+）。CABG术后，除2例患者外，其余患者心功能均为1级。在43例接受药物治疗的患者中，31例（72%）心功能分级为3级或4级。血管造影结果显示，5例患者有3+ MR，14例有2+ MR，24例有1+ MR。23例患者的射血分数小于30%，20例患者的射血分数大于或等于30%，且左心室充盈压升高。20例患者死亡，平均随访期为11个月。我们的研究表明，与药物治疗的患者相比，接受手术治疗的患者MR的血管造影表现有所改善，功能状态得到改善，症状得到缓解。我们认为，一部分伴有MR和CAD的患者将从CABG中获益。
