Özet:

The development of mitral insufficiency associated with ischemic heart disease, still operational mortality, is a high prevalent disease. As a surgical procedure, there has not yet been an agreement. In this study, the aim is to show each other their advantages by comparing ischemic mitral failure (IMY), mitral cover replacement (MVR) and repair results. Materials and Methods: Between 2007 and 2011 in the Higher Special Education and Research Hospital of Turkey, 36 patients operated due to IMY have been examined. The patients (38.9%) were female and 22 (61.1%) male. 20 patients received MVR, 16 patients received mitral reconstruction. In both groups there was a coronary bypass in all cases. Preoperative risk factors, the degree of mitral insufficiency, left ventricular ejection fractions, prepostoperative functional classifications, aort cross clemp and cardiopulmonary bypass periods, intensive care and hospital stay periods were determined in patients. Results: The MVR group has a significant difference between the preoperative diastolic diameter and the control diastolic diameter (p=0.016). The improvement in the diastolic range in this group was statistically better compared to the repair group. There was also a significant difference in the direction of improvement between preoperative functional capacity (FK) and control FK (p=0.008). When early mortality was studied, 6 patients in the MVR group, 5 patients in the repair group were exitus. There was no significant difference when compared with 11 patients with mortality with survivors in the direction of the preoperative injection fraction (EF) (p=0.986) Result: Although the IMY first suggested mitral repair, as suggested in some recent studies, the MVR makes it possible to complete the mitral deficiency and reduce the risk of reoperation. Keywords: ischemic heart disease is still a disease with high operative mortality, ischemic heart disease is still a disease with high operative mortality, ischemic heart disease is still a disease with high operative mortality. There is still no consensus as surgical procedure. In this study, it is aimed to reveal the superiority of ischemic mitral insufficiency (IMI), mitral valve replacement (MVR) and repair results. Materials and Methods: 2007 and High-Turkey Training and Research Hospital between the years of 2011, 36 patients were operated for IMI was examined. The patients (38.9%) were female and 22 (61.1%) were male. MVR was performed in 20 patients and mitral reconstruction was performed in 16 patients. There was coronary bypass in all cases. Preoperative risk factors, degree of mitral regurgitation, left ventricular ejection fractions, pre-postoperative functional classifications, aortic cross clamp and cardiopulmonary bypass duration, intensive care and hospital stay were determined. Results: There was a significant difference between preoperative diastolic diameter and control diastolic diameter in the MVR group (p = 0.016). In this group diastolic diametric improvement was statistically better than the repair group. Furthermore, there was a significant difference between the preoperative functional capacity (FC) and control FC in terms of improvement (p = 0.008). When the patients with early mortality were examined, 6 patients in the MVR group and 5 patients in the repair group died. There was no significant difference between 11 patients with mortality and the survivors in terms of preoperative ejection fraction (EF) (p = 0.986). Conclusion: Although mitral repair is recommended in IMI, as recently suggested in some studies, MVR provides complete removal of mitral insufficiency and reduces the risk of reoperation. Keywords: Ischemic Mitral Insufficiency, Coronary Artery By-Pass Grafting, Mitral Valve Replacement, Mitral Repair