Repair vs. Replacement in Ischemic Mitral Regurgitation: Outcomes at 2 Years

No difference was observed in left ventricular remodeling, but there was a higher rate of recurrent MR after repair.

These authors report on 2-year findings from a randomized trial comparing mitral valve repair, primarily with restrictive annuloplasty (12% had subvalvular repair procedures), to chordal-sparing mitral valve replacement in 251 patients with severe ischemic mitral regurgitation (MR). Concomitant coronary artery bypass grafting was performed in 75% of patients. The 1-year results were previously reported (NEJM JW Cardiol Jan 2014 and N Engl J Med 2014; 370:23).

The primary endpoint of left ventricular end-systolic volume index (LVESVI) on echocardiography at 2 years was similar in the two groups (change from baseline: repair, −9.0 mL/m²; replacement, −6.5 mL/m²). Mortality was also similar at 2 years, but moderate or severe MR occurred signifi…

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)