• Farideh Roshanali, Saeed Shoar, Nasrin Shoar, Mohammad Naderan, Farshid Alaeddini, and Mohammad Hossein Mandegar.
• Department of Cardiology, Day General Hospital, Tehran, Iran.
• J. Thorac. Cardiovasc. Surg.. 2014 Oct 1;148(4):1323-7.

BackgroundThe ideal management of ischemic mitral regurgitation (MR) remains a clinical dilemma because of the suboptimal available therapeutic options. Recently, new concepts have emerged, pointing to the benefits of a patient selection approach when debating the management of moderate ischemic MR. We investigated the predictability of low-dose dobutamine stress echocardiography (DSE) in selecting candidates for CABG with moderate MR for valve repair.MethodsFrom November 2002 to May 2010, 110 candidates for first-time CABG, who were admitted to the cardiac surgery department in Day General Hospital (Tehran, Iran), were enrolled in the present cross-sectional study. DSE was performed for each case before CABG. Those with positive findings underwent CABG alone and those with negative results underwent concomitant CABG and mitral valve repair. The patients were followed up for a minimum of 60 months.ResultsOf the 110 patients, 47 (42.72%) had positive test results and underwent CABG alone and 63 (57.28%) had negative DSE results and underwent concomitant CABG and mitral valve repair. The MR degree had decreased from 2.8±0.3 preoperatively to 1.46±0.6 early during the hospital stay and 1.9±0.7 during late follow-up in the CABG group. It had decreased from 2.84±0.4 preoperatively to 0.93±0.65 postoperatively but then increased to 1.41±0.9 during late follow-up, for a significant decrease in the combined group (P<.05).ConclusionsDespite its utility in selecting CABG patients with moderate ischemic MR for valve repair from a short-term perspective, the use of DSE cannot predict the long-term outcomes of these patients.Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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