Summary
This randomised controlled trial of 301 patients compared coronary-artery bypass grafting (CABG) alone with CABG plus mitral-valve repair in moderate ischaemic mitral regurgitation. At 2 years, both groups showed similar left ventricular reverse remodelling and mortality (approximately 10%), though the combined procedure reduced residual mitral regurgitation (11.2% vs 32.3%) at the cost of higher neurologic events and arrhythmias. The study suggests mitral-valve repair provides more durable haemodynamic correction but does not improve overall survival or reduce major adverse events.
UK applicability
This study's findings from a multi-centre cardiac surgical trial are directly applicable to UK cardiothoracic practice, informing surgical decision-making in the National Health Service. However, the record is not relevant to Vitagri's focus on farming systems, soil health, nutrient density, and food-systems research.
Key measures
Left ventricular end-systolic volume index (ml per square meter of body-surface area), mortality rate (%), prevalence of moderate or severe residual mitral regurgitation (%), hospital readmission rate, 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 2-year follow-up in patients undergoing coronary-artery bypass grafting with or without concomitant mitral-valve repair.
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