ISCHEMIC MITRAL-VALVE DISEASE - CLASSIFICATION AND SYSTEMIC APPROACH TO MANAGEMENT

One hundred sixty-nine consecutive patients with coronary artery disea se and mitral valve pathology operated during the past 5 years were re viewed (98% follow-up). Eighty-seven patients underwent mitral valve r epair and 82 mitral valve replacement with concomitant coronary artery bypass grafting (number of AV grafts = 3). An analysis of these patie nts (age range 48 to 92 [mean 69]) and a classification based on anato mic pathology of the mitral apparatus is presented. Flexible ring annu loplasty was utilized in all repairs and chordal-sparing techniques in all valve replacements. There was equal mortality for replacement and repair in this subset of high risk patients. Structural valve dysfunc tion of repaired valves was more common (5/81 [6.0%]) than primary tis sue valve failure after mitral valve replacement (0 patients).