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New Study May Impact Practice Guidelines for Mitral Valve Surgery for Severe Ischemic Mitral Regurgitation
Date:11/19/2013

atrium from the left ventricle of the heart due to improper closure of the mitral valve. The condition often develops as a complication from a heart attack and subsequent enlargement of the left ventricle, the heart’s main pumping chamber. If not surgically corrected, the condition has been reported to potentially have a one-year mortality risk as high as 40 percent.

Currently, practice guidelines recommend valve repair or replacement for severe ischemic mitral regurgitation. However, lack of evidence has led to uncertainty and variation in surgical practice, although surgeons’ use of repair has increased over time. Previous research has shown mitral valve repair has lower operative mortality and complications, while mitral valve replacement may provide better long-term correction of mitral regurgitation.

“These results may impact the surgical care of patients experiencing severe ischemic mitral regurgitation and offer the strongest evidence to date to inform future surgical practice guidelines,” says Michael K. Parides, PhD, Professor of Biostatistics in the Department of Health Evidence and Policy at Icahn School of Medicine at Mount Sinai, the principal statistician for the CTSN.

This multicenter, randomized clinical trial included 22 clinical centers in North America randomizing 251 patients. It evaluated the safety and effectiveness of mitral valve repair and mitral valve replacement in patients with severe ischemic mitral regurgitation. Comparative effectiveness was based on the degree of left ventricular remodeling, mortality, adverse events, recurrent mitral regurgitation, hospitalizations, and quality of life one-year after surgery.

“While our study results clearly demonstrate that patient outcomes with replacement and repair are similar one-year after surgery, our ongoing patient follow-up is extremely important, as
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