Ischemic mitral regurgitation: different surgical approaches
. This review presents an analysis of the problems of surgical treatment of ischemic mitral regurgitation with an emphasis on mechanisms of ischemic mitral insufficiency, which largely determine the method of surgical correction. It also presents the results of several variants of surgical correction of ischemic mitral insufficiency. The basic mechanism of ischemic mitral regurgitation - is caused by myocardial ischemia left ventricular remodeling, which leads to a papillary muscles displacement and mitral valve apical tenting. Patients with ischemic mitral insufficiency overthroweth various methods of surgical correction: myocardial revascularization, restrictive mitral valve annuloplasty combined with coronary bypass surgery, mitral valve replacement with preservation of subvalvular apparatus, and other alternative methods to correct subvalvular apparatus and left ventricular morphology. These surgical approaches can be effective, but the surgical choice for correction of ischemic mitral regurgitation is unique enough.