Comparison of surgical outcomes in patients with heart failure with reduced ejection fraction combined with moderate ischemic mitral regurgitation: a single-center retrospective study.

Background: Coronary artery bypass grafting (CABG) is associated with a high surgical risk in patients with heart failure with reduced ejection fraction (HFrEF) and moderate ischemic mitral regurgitation (IMR). This study aimed to compare clinical outcomes between isolated CABG and combined CABG plus mitral valve surgery (MVS) in this population. Methods: This was a single-center, retrospective cohort study analyzing the clinical data of patients with coronary artery disease (CAD) combined with HFrEF and moderate IMR who underwent surgical revascularization. Patients with off-pump CABG were excluded to eliminate the possible effects of cardiopulmonary bypass (CPB). Finally, 158 patients were divided into CABG-alone group (n=117) and combined-MVS group (n=41). Clinical data and follow-up results were then compared. Results: Perioperative mortality was 7.6% (12/158), with no difference between groups [CABG-alone 6.8% Conclusions: Combined CABG plus MVS may reduce the recurrence rate of MR at 1 year postoperatively and improve the NYHA cardiac function class in high-risk patients with HFrEF and moderate IMR, but survival outcomes did not differ from isolated CABG. These findings support isolated CABG as a viable option.