When Should Patients with Ischemic Mitral Regurgitation Undergo Cardiac Surgery?
Ischemic mitral regurgitation (MR) is a frequent entity that is often overlooked in the setting of acute or chronic coronary disease [1, 2]. The prevalence of this disorder varies between 10 and 30% of MR cases. The papillary muscles are particularly jeopardized by acute ischemia, and the posteromedial muscle (perfused by the posterior descending coronary artery) is more vulnerable than the anterolateral one (perfused by branches of the anterior and circumflex coronary arteries). The posteromedial muscle is perfused by one vessel in 63% of patients, whereas the anterolateral muscle receives blood from the two major coronary branches in 73% of patients . MR following acute myocardial infarction (AMI) develops in 15% of patients suffering from an anterior insult as compared to 40% of those with an inferior infarction. Functional MR after the ischemic insult, or induced by myocardial ischemia and transient papillary-muscle-related myocardial wall dysfunction, is therefore characterized by preserved valve integrity.
KeywordsMitral Regurgitation Papillary Muscle Severe Mitral Regurgitation Functional Mitral Regurgitation Ischemic Mitral Regurgitation
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