Severe Functional Ischemic Mitral Regurgitation: Repair or Replace the Valve?

Outcomes of both procedures were similar at 1 year.

Functional mitral regurgitation (MR), usually resulting from ischemic heart disease, is associated with increased mortality, either from the MR itself or from the underlying cardiac disease. Most patients with severe symptoms undergo valve surgery, but whether repair is better than replacement is unclear. In this multicenter, randomized trial, investigators assigned 251 patients with severe ischemic MR (effective orifice area >0.4 cm²; average ejection fraction, about 40%) to either valve replacement with complete preservation of the chords and subvalvular apparatus or repair with a downsized annuloplasty ring. In both groups, three quarters of the patients underwent concomitant coronary artery bypass grafting.

At 12 months, the primary endp…

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)