Ringless alfieri mitral valve repair for significant ischemic mitral regurgitation with coronary artery bypass grafting.

BACKGROUND Ischemic mitral regurgitation (IMR) is associated with diminished survival prospects. Ringless edge-to-edge mitral valve repair is usually performed in association with coronary artery bypass grafting (CABG). In this report, we present our early results for ringless edge-to-edge repair and concomitant CABG. METHODS Between January 2011 and June 2012, 17 patients underwent ringless edge-to-edge mitral valve repair. The cause was ischemic in all patients. A double-orifice repair was done in all patients. Complete coronary revascularization was routinely added in all cases. RESULTS There were no hospital and late deaths. Low cardiac output developed in 5 patients (29.41%) and was treated with inotropic agents. Two of these patients required intraaortic balloon pump support. Atrial fibrillation and ventricular arrhythmia developed in 5 (29.41%) of the patients, and all of them converted to sinus rhythm with antiarrhythmic agents. The mean (SD) stays in the intensive care unit and the hospital were 2.83 ± 1.29 days and 7.74 ± 2.14 days, respectively. As of the latest follow-up, all patients were in New York Heart Association class I or II. There was no recurrent mitral valve regurgitation or valve-related complications. CONCLUSIONS Alfieri mitral valve repair is associated with lower risks of mortality, postoperative stroke, and prolonged intensive care unit and hospital stays. Alfieri mitral valve repair and concomitant CABG surgery can be performed in patients with IMR.