Impact of Moderate Ischemic Mitral Regurgitation After Isolated Coronary Artery Bypass Grafting Khalil Fattouch, MD, PhD, Roberta Sampognaro, MD, Giuseppe.

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Impact of Moderate Ischemic Mitral Regurgitation After Isolated Coronary Artery Bypass Grafting Khalil Fattouch, MD, PhD, Roberta Sampognaro, MD, Giuseppe Speziale, MD, Massimo Salardino, MD, Giuseppina Novo, MD, Marco Caruso, MD, Salvatore Novo, MD, Giovanni Ruvolo, MD The Annals of Thoracic Surgery Volume 90, Issue 4, Pages 1187-1194 (October 2010) DOI: 10.1016/j.athoracsur.2010.03.103 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Overall survival rate (± SE) according to the presence of moderate ischemic mitral regurgitation (IMR). Five-year survival rate for patients without IMR (dashed line) versus patients with moderate IMR (dotted line) was 90.5% ± 1.8% versus 73.7% ± 2.1%, respectively (p < 0.001). The Annals of Thoracic Surgery 2010 90, 1187-1194DOI: (10.1016/j.athoracsur.2010.03.103) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Freedom from cardiac-related death according to presence of moderate ischemic mitral regurgitation (IMR). Five-year freedom from cardiac-related death in group of patients without IMR (dashed line) versus patients with moderate IMR (dotted line) was 94.2% ± 1.6% versus 79.5% ± 1.5%, respectively (p < 0.001). The Annals of Thoracic Surgery 2010 90, 1187-1194DOI: (10.1016/j.athoracsur.2010.03.103) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Freedom from cardiac-related death in all patients with moderate ischemic mitral regurgitation (IMR) and patients without ischemic mitral regurgitation according to the ejection fraction (EF). Five-year freedom from cardiac-related death was 68.9% ± 2.8% for patients with moderate IMR and EF 40% or less (dashed line; p < 0.0001), 89.5% ± 3.1% for patients with moderate IMR and EF greater than 40% (dotted line), 93.2% ± 1.8% for patients without IMR and EF 40% or less (square line), and 95.3% ± 1.2% for patients without IMR and EF greater than 40% (solid line). The Annals of Thoracic Surgery 2010 90, 1187-1194DOI: (10.1016/j.athoracsur.2010.03.103) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Freedom from cardiac-related events was 62.1% ± 1.2% for patients with moderate ischemic mitral regurgitation (IMR [dotted line]) and 88.2% ± 2.1% (p < 0.0001) for patients without IMR (dashed line). The Annals of Thoracic Surgery 2010 90, 1187-1194DOI: (10.1016/j.athoracsur.2010.03.103) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Freedom from cardiac-related events in patients with moderate ischemic mitral regurgitation (IMR) and in patients without IMR according to ejection fraction (EF): p less than 0.0001 for moderate IMR and EF 40% or less (dashed line) versus no IMR group (square line), and p less than 0.001 for moderate IMR and EF greater than 40% (dotted line) versus no IMR (solid line). The Annals of Thoracic Surgery 2010 90, 1187-1194DOI: (10.1016/j.athoracsur.2010.03.103) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Evaluation under exercise testing of survivor patients with mild or moderate ischemic mitral regurgitation (MR). (ERO = effective regurgitant orifice area; Pts = patients.) The Annals of Thoracic Surgery 2010 90, 1187-1194DOI: (10.1016/j.athoracsur.2010.03.103) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions