الفهرس 
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Abstract
CIMR is becoming the focus of an increasing amount of cardiovascular research. cIMR is present in 10% to 20% of patients with CAD, and is a common cause of post-MI congestive heart failure. Treatment of cIMR still remains a challenge. Results from the literature are not uniform, and principles of surgical treatment are not clearly stated.
This study was conducted on 70 patients from June 2010 to December 2012. It was done between Cardiac Surgery Unit, Nasser Institute for research and treatment, Cairo and Cardiothoracic Surgery Department, Mansoura University Hospitals. The 70 patients were randomly classified into 2 groups; each is 35 patients; the 1st was subjected to CABG alone (group A); while the 2nd group was subjected to CABG and MV surgery (group B).
from our study we concluded that:
There are 5 items in favor of correction of IMR together with CABG reflecting the real value of MR correction on patient clinical status and echocardiographic finding.
Eighteen items are in favor of CABG only, reflecting mainly the hazards of the longer CPB and cross clamp time in group B rather than actual advantages in CABG alone.
So, we recommend from this study unless the CPB time and cross clamp time could be reduced to the lowest limit to alleviate their hazards, or to perform off pump CABG then to go on pump to perform mitral surgery, it looks safe to only and completely revascularize these patients.
Moderate cIMR is in the gray zone of surgical decision-making. from a surgeon’s viewpoint, it is ethical to either repair or replace the IMR in addition to CABG in these patients than to leave it behind. But “perfect is the enemy of good”.