الفهرس 
ANATOMY OF MITRAL VALVE AND CORONARY CIRCULATIONOnly 14 pages are availabe for public view
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Abstract
Background: Ischemic mitral regurgitation is a serious consequence of coronary artery disease, in particular myocardial infarction that carries a substantial risk of death from cardiovascular causes in proportion to its severity. Mitral valve interventions must be done in severe ischemic mitral regurgitation concomitant with CABG surgery in operable patients. Mitral valve replacement and mitral valve repair are two surgical options for surgical treatment of severe ischemic mitral regurgitation, and the choice of surgery is variable.
Aim of study: To compare between mitral valve repair versus replacement in severe ischemic mitral regurgitation, in peri-operative mortality, all-cause late mortality, re-operation, recurrence of MR after surgery and reverse remodeling after surgery, to determine the best surgical option to treat severe ischemic mitral regurgitation .
Methods: Electronic searches were performed using Google, plumbed, embase to January 2020, and the search terms: mitral, ischemic mitral regurgitation, mitral valve repair, mitral valve replacement, coronary artery bypass grafting, mortality or death. We selected the studies that compared mitral valve replacement versus repair in severe ischemic mitral regurgitation and a meta- analysis was done between them.
Results: Mitral valve replacement (with a mechanical or a bioprosthetic valve) with complete preservation of both leaflets, is a viable option to treat severe ischemic mitral regurgitation in operable patients concomitant with CABG surgery, because the rates of recurrence of MR is high after repair with annuloplasty ring with high rates of re-operation, heart failure and death. No evidence that MV repair has a superiority in reducing peri-operative mortality versus replacement, both techniques have a good reverse remodeling after surgery concomitant with CABG surgery. All causes of late mortality are related to the patient’s characteristics and the degree of heart failure.
Conclusions: Mitral valve replacement with complete preservation of both leaflets is a viable option to treat severe ischemic mitral regurgitation in operable patients concomitant with CABG surgery.
Key words: CABG, ischemic mitral regurgitation, mitral valve replacement, mitral valve repair.