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

Thursday, January 28, 2016

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Source

Source Name: New England Journal of Medicine

Source URL: http://www.ncbi.nlm.nih.gov/pubmed/?term=26550689

Author(s)

Goldstein D, Moskowitz AJ, Gelijns AC, Ailawadi G, Parides MK, Perrault LP, Hung JW, Voisine P, Dagenais F, Gillinov AM, Thourani V, Argenziano M, Gammie JS, Mack M, Demers P, Atluri P, Rose EA, O'Sullivan K, Williams DL, Bagiella E, Michler RE, Weisel RD, Miller MA, Geller NL, Taddei-Peters WC, Smith PK, Moquete E, Overbey JR, Kron IL, O'Gara PT, Acker MA.

In this Cardiothoracic Surgical Trials Network (CTSN) trial 251 patients with ischemic mitral regurgitation were randomized to mitral-valve repair or mitral-valve replacement. The current publication reports the 2-year outcomes of the trial.

This trial shows that there was no significant difference in two-year survival between repair and replacement (19.0% vs 23.2%, HR 0.79, 0.46-1.35), although the trial was not powered to study survival. There was no difference in left ventricular end-systolic volume index between the two treatments. Recurring moderate or severe mitral regurgitation was seen more frequently in the repair group (58.8% versus 3.8%, p<0.001), as well as more cardiovascular admissons and heart-failure related adverse events.