The Impact of Percutaneous Coronary Intervention on Ischemic Mitral Regurgitation

Background and aim of the study: The study aim was to determine if significant ischemic mitral regurgitation (IMR) is adequately addressed in patients undergoing multi-vessel percutaneous coronary intervention (PCI). Methods: The cardiac catheterization laboratory database at the authors' institution was accessed over a five-year interval to identify those patients who had undergone multi-vessel PCI. Both, pre- and post-revascularization echocardiographic data were retrieved, and clinical data, MR presence and severity, and outcomes were each assessed. Results: In total, 150 patients (100 males, 50 females; mean age 63 +/- 12 years) underwent PCI. Of these 150 patients, pre-procedural echocardiograms were not performed in 54 cases (35%); hence, the study group comprised 96 patients with both pre- and post-procedural echocardiograms. Of these patients, 21 (22%) had moderate or greater (2+) IMR. The severity of the IMR did not change significantly after multivessel PCI (2 +/- 0.8+ preoperatively versus 1.9 +/- 1.0+ postoperatively). Conclusion: Clinically significant IMR occurred not infrequently among patients treated with multivessel PCI, but the severity did not change with percutaneous revascularization, despite this being predominantly complete. In more than one-third of the patients, adequate pre-PCI echocardiography was unavailable, which suggested the possibility that not all IMR had been identified. The Journal of Heart Valve Disease 2012;21:564-569