Valve Repair with Bypass Strengthens Hearts

Mitral valve repair performed with bypass surgery improves heart function

(RxWiki News) Heart patients in need of a coronary artery bypass graft to improve blood flow to the heart appear to have the most success when that procedure is combined with the repair of heart valves.

Bypass patients who also had leaking mitral heart valves repaired were found to have better heart function than patients who only had bypass surgery.

The mitral valve has two flaps that separate the heart's upper and lower chambers on the left side. The valves may leak if they do not close properly.

"Ask your cardiologist if you could benefit from valve repair."

Dr. K. M. John Chan, the study’s lead author and a senior clinical research fellow at Imperial College in the United Kingdom, noted that many patients receiving bypass surgery have mild to moderately leaky mitral valves because coronary artery disease causes the heart to enlarge. When this happens the mitral valve is pulled apart.

The dual procedure is usually reserved for patients that have severe valve leaks. Surgeons usually do not repair moderate valve leaks during surgery, but Dr. Chan noted that patients with leaking valves tend to fare worse after surgery.

During the study researchers randomly selected 60 patients to receive a coronary artery bypass graft only, or bypass surgery and mitral valve repair. All of the patients had moderate valve leaks caused by ischemic heart disease.

Investigators tested the participants' exercise capacity, heart function and heart size before surgery and one year later. They found that patients that received the dual procedure had increased heart functioning, and exercise capability improved to 3 ml/kg/min compared to 1 ml/kg/min in patients who received only a bypass operation.

They also discovered that heart size was reduced 24 percent toward a normal size in patients that received the dual procedure as compared to 10 percent in those who received only bypass surgery.

Blood levels of plasma-BNP, which is linked to heart failure, also were lower in patients that received both procedures. The blood marker was at 108.9 pmol/l in patients that received only bypass surgery as compared to 54.8 pmol/l in patients who received bypass surgery and valve repair.

The research was presented today in an American Heart Association Emerging Science Series webinar. The study was funded by the United Kingdom Department of Health, British Heart Foundation and British Medical Association.

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Review Date: 
February 29, 2012