{
  "abstract": "Objectives\n\nFor patients with end-stage ischemic cardiomyopathy undergoing coronary artery bypass grafting (CABG), the indications for concomitant repair of moderate mitral regurgitation (MR) remain controversial. This study evaluated outcomes of concomitant mitral valve repair (MVr) for moderate ischemic MR in patients with advanced left ventricular (LV) remodeling and severely impaired LV function undergoing CABG.Methods\n\nWe retrospectively reviewed 341 patients (mean age, 67 ± 9 years) with ischemic cardiomyopathy (LV ejection fraction, ≤40%) and less-than-severe MR who underwent CABG. Of these, 108 (32%) underwent concomitant MVr for clinically relevant moderate MR, and 233 (68%) underwent CABG alone for mild or absent MR. All patients had a prior myocardial infarction. The primary end point was overall survival. Secondary end points included postoperative changes in MR grade and LV function at 1 year. Median follow-up was 4.5 years (interquartile range, 2.4-7.3 years).Results\n\nDespite higher preoperative surgical risk in the CABG + MVr group (European System for Cardiac Operative Risk Evaluation II score, 6.7% vs 2.9%; P < .001), 30-day mortality did not differ between groups (1.9% vs 2.1%; P = .88). Five-year overall survival was 73% versus 77% (log-rank P = .25). At 1 year, the CABG + MVr group demonstrated greater LV reverse remodeling (median LV end-diastolic volume index reduction: -26% vs -19%; P = .001), higher LV ejection fraction (46 ± 13% vs 42 ± 12%; P = .044), and a lower prevalence of significant MR (6% vs 13%; P = .032).Conclusions\n\nIn patients with advanced ischemic cardiomyopathy and moderate MR, concomitant MVr can be performed with acceptable operative risk and promotes superior LV reverse remodeling. Long-term survival was comparable to patients with nonsignificant MR who did not require mitral intervention, suggesting that targeted mitral repair may normalize the adverse prognostic influence of moderate ischemic MR.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiovascular Surgery, The University of Osaka Graduate School of Medicine, Osaka, Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yusuke Misumi"
    },
    {
      "affs": [
        0
      ],
      "name": "Daisuke Yoshioka"
    },
    {
      "affs": [
        0
      ],
      "name": "Shin Yajima"
    },
    {
      "affs": [
        0
      ],
      "name": "Takuji Kawamura"
    },
    {
      "affs": [
        0
      ],
      "name": "Ai Kawamura"
    },
    {
      "affs": [
        0
      ],
      "name": "Kazuma Handa"
    },
    {
      "affs": [
        0
      ],
      "name": "Akinobu Ohtani"
    },
    {
      "affs": [
        0
      ],
      "name": "Shunsuke Saito"
    },
    {
      "affs": [
        0
      ],
      "name": "Kazuo Shimamura"
    },
    {
      "affs": [
        0
      ],
      "name": "Shigeru Miyagawa"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/97qwg5aabajtg.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.101963",
  "fulltext_url": "https://europepmc.org/articles/PMC13711187",
  "id": "97qwg5aabajtg",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948419",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Adult: Mitral Valve"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7167923747",
  "pdf_url": "https://europepmc.org/articles/PMC13711187?pdf=render",
  "pmcid": "PMC13711187",
  "pmid": "42948419",
  "published": "2026-07-10",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/97qwg5aabajtg.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:36Z",
      "native_id": "MED:42948419",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948419"
    },
    {
      "first_seen": "2026-10-31T12:22:00Z",
      "native_id": "PMC13711187",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.101963"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Mitral repair for moderate ischemic mitral regurgitation in patients with end-stage ischemic cardiomyopathy.",
  "title_text": "Mitral repair for moderate ischemic mitral regurgitation in patients with end-stage ischemic cardiomyopathy.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:00Z",
  "url": "https://research.draconitic.com/paper/97qwg5aabajtg",
  "venue": "JTCVS open",
  "versions": []
}