Two-Year Outcomes of Surgical Treatment of Moderate Ischemic Mitral Regurgitation

After 2 years of follow-up in a randomized trial involving 301 patients with moderate ischemic mitral regurgitation undergoing CABG, the addition of mitral-valve repair did not improve left ventricular function or remodeling. Ischemic mitral regurgitation of moderate severity develops in approximate...

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Bibliographic Details
Published in:	The New England journal of medicine Vol. 374; no. 20; pp. 1932 - 1941
Main Authors:	Michler, Robert E, Smith, Peter K, Parides, Michael K, Ailawadi, Gorav, Thourani, Vinod, Moskowitz, Alan J, Acker, Michael A, Hung, Judy W, Chang, Helena L, Perrault, Louis P, Gillinov, A. Marc, Argenziano, Michael, Bagiella, Emilia, Overbey, Jessica R, Moquete, Ellen G, Gupta, Lopa N, Miller, Marissa A, Taddei-Peters, Wendy C, Jeffries, Neal, Weisel, Richard D, Rose, Eric A, Gammie, James S, DeRose, Joseph J, Puskas, John D, Dagenais, François, Burks, Sandra G, El-Hamamsy, Ismail, Milano, Carmelo A, Atluri, Pavan, Voisine, Pierre, O’Gara, Patrick T, Gelijns, Annetine C
Format:	Journal Article
Language:	English
Published:	United States Massachusetts Medical Society 19-05-2016
Subjects:	Clinical outcomes Clinical trials Coronary artery Coronary Artery Bypass Female Follow-Up Studies Heart Heart surgery Humans Ischemia Length of Stay Male Mitral Valve - surgery Mitral Valve Insufficiency - etiology Mitral Valve Insufficiency - mortality Mitral Valve Insufficiency - surgery Myocardial Infarction - complications Myocardial Infarction - surgery Patient Readmission - statistics & numerical data Patients Postoperative Complications Quality of Life Regurgitation Stroke - etiology Survival Tachycardia, Supraventricular - etiology Ventricle Ventricular Remodeling New York United States > US
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Summary:	After 2 years of follow-up in a randomized trial involving 301 patients with moderate ischemic mitral regurgitation undergoing CABG, the addition of mitral-valve repair did not improve left ventricular function or remodeling. Ischemic mitral regurgitation of moderate severity develops in approximately 10% of patients after myocardial infarction. 1 , 2 Mitral regurgitation is caused by the displacement of papillary muscle, leaflet tethering, reduced closing forces, and annular dilatation. Over time, the condition has an adverse effect on the rate of survival free of heart failure. 3 Because most patients with ischemic mitral regurgitation have multivessel coronary artery disease requiring revascularization, surgeons have to consider whether to add mitral-valve repair to coronary-artery bypass grafting (CABG). The appropriate surgical management of moderate ischemic mitral regurgitation at the time of CABG remains controversial. Some experts advocate revascularization alone . . .
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-News-2 ObjectType-Feature-3 content type line 23 Drs. Michler and Smith contributed equally to this article. A list of members of the Cardiothoracic Surgical Trials Network (CTSN) is provided in the Supplementary Appendix, available at NEJM.org
ISSN:	0028-4793 1533-4406
DOI:	10.1056/NEJMoa1602003