Summary
This randomised controlled trial compared coronary-artery bypass grafting (CABG) alone with combined CABG and mitral-valve repair in 301 patients with moderate ischaemic mitral regurgitation, following patients for two years. At two years, both groups showed similar left ventricular reverse remodelling and mortality rates, though the combined procedure group had significantly lower rates of residual mitral regurgitation but higher rates of neurologic events and supraventricular arrhythmias. The findings suggest that whilst mitral-valve repair provides more durable correction of regurgitation, it does not confer survival or overall adverse-event benefits over CABG alone in this patient population.
UK applicability
These findings are relevant to UK cardiothoracic surgical practice and clinical guidance on the management of moderate ischaemic mitral regurgitation in patients undergoing CABG. The results may inform surgical decision-making in the NHS regarding the role of concomitant mitral-valve repair, though applicability depends on case selection and surgeon expertise.
Key measures
Left ventricular end-systolic volume index (LVESVI) in ml per square metre of body-surface area; mortality rate; prevalence of moderate or severe residual mitral regurgitation; hospital readmission rates; serious adverse events; neurologic events; supraventricular arrhythmias
Outcomes reported
The study measured left ventricular end-systolic volume index (LVESVI), mortality rates, prevalence of residual mitral regurgitation, and rates of adverse events at two years post-surgery. Clinical and echocardiographic outcomes were compared between CABG alone and CABG plus mitral-valve repair groups.
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