Surgical Treatment of Moderate Ischemic Mitral Regurgitation

In this prospective randomized study from the Cardiothoracic Trials Network Investigators, the authors compare the results between CABG alone and CABG plus mitral valve repair in 301 patients with ischemic moderate mitral insufficiency and coronary artery disease. In these patients, the addition of mitral valve repair with a rigid or semirigid complete annuloplasty ring to CABG, was not associated with greater improvement in the left ventricular end-systolic volume index (primary endpoint) at 1 year. There were also no significant differences between the groups in mortality, the composite end point of cardiac or cerebrovascular events, readmissions, or quality of life. There were more neurological events in the CABG plus repair group. The authors conclude that, at one-year follow up, there is no meaningful advantage in adding mitral valve annuloplasty in patients with moderate ischemic mitral insufficiency undergoing CABG.