Should Mitral Regurgitation Be Repaired During CABG?

An observational analysis of STICH trial data suggests improved survival in patients with substantial MR who undergo concomitant valve repair.

Whether or not to repair mitral regurgitation (MR) at the time of coronary artery bypass grafting (CABG) is controversial. In this retrospective study of data from the Surgical Treatment for Ischemic Heart Failure (STICH) trial (JW Cardiol Apr 4 2011), investigators compared the effects of CABG alone, CABG with MR repair (at the operator's discretion), and medical therapy alone in 1209 patients with coronary artery disease who were candidates for CABG and had left ventricular ejection fractions of 35% or less. Baseline MR severity was none or trace in 36% of participants, mild in 46%, moderate in 15%, and severe in 3%.

In the medical-therapy group, MR severity was strongly associated with mortality at a median follow-up of 56 months (hazard …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)