Long-term results of operations for mitral insufficiency secondary to coronary artery disease.

There are few published reports regarding the long-term results of the operative treatment of significant mitral insufficiency secondary to coronary artery disease. The few available reports deal with mitral replacement and myocardial revascularization. However, we prefer mitral repair to mitral replacement with myocardial revascularization. Eighty-seven patients were operated upon with ejection fractions between 0.1 and normal. In 16 patients it was necessary to replace the mitral valve; however, the valve was repaired in the remaining 71 patients. By actuarial curve the survival rate at 9 years was 60 percent for the entire series, and 18 percent in the 16 patients with mitral valve replacement and revascularization. This contrasted with a 73 percent survival rate for those patients with repair of the mitral valve and revascularization. We feel strongly that if repair is done properly, it is far superior to mitral valve replacement for the patient with mitral insufficiency secondary to coronary artery disease.