Navigation Links
Study may impact guidelines for mitral valve surgery for severe ischemic mitral regurgitation

The Cardiothoracic Surgical Trials Network (CTSN), whose Data and Clinical Coordinating Center is at Icahn School of Medicine at Mount Sinai, is reporting for the first time evidence on whether or not there is any significant difference between the two current surgical approaches to treat patients with severe ischemic mitral regurgitation -- mitral valve repair and mitral valve replacement.

The findings presented on November 18 at the American Heart Association's Scientific Sessions 2013 and published simultaneously by the New England Journal of Medicine, report similar clinical outcomes one-year following mitral valve surgery for both surgical approaches. Although patient clinical outcomes were similar, mitral valve replacement was shown to be more durable than repair.

"Ischemic mitral regurgitation is an important public health problem affecting as many as two million Americans. Our study is the first definitive clinical trial to address the relative merits of mitral valve repair versus mitral valve replacement surgery in patients suffering from severe ischemic mitral regurgitation," says Annetine C. Gelijns, PhD, Professor and Chair of the Department of Health Evidence and Policy at Icahn School of Medicine at Mount Sinai, who is the corresponding author for the NEJM study and principal investigator for the Data and Clinical Coordinating Center based at Mount Sinai for the NIH-sponsored Cardiothoracic Surgical Trials Network (CTSN) which conducted the clinical trial study.

Ischemic mitral regurgitation occurs when blood backflows into the left 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 it will reveal any consequences for patients whose mitral regurgitation has recurred," says Alan J. Moskowitz, MD, Professor and Vice-Chair of the Department of Health Evidence and Policy at Icahn School of Medicine at Mount Sinai and study co-author.

The CTSN has eight core clinical centers in the U.S. and Canada. The CTSN Data and Clinical Coordinating Center, based at Icahn School of Medicine at Mount Sinai, directs each of its clinical trial's design, methodologies, ethical research concerns, study data, analysis, and reporting.


Contact: Lauren Woods
The Mount Sinai Hospital / Mount Sinai School of Medicine

Related medicine news :

1. Advanced CT imaging proves as accurate as invasive tests to assess heart blockages, study shows
2. Chicago man breathes again thanks to Northwestern Medicine study
3. Study finds youth prefer and benefit more from rapid point-of-care HIV testing
4. Study: Ureteral injury during robot-assisted prostate surgery
5. Study: Odds of rehospitalization of cognitively impaired varies by discharge destination
6. A CNIO study recreates the history of life through the genome
7. Dr. Joe Dentistry Promotes Dental Exams as New Study Links Heart Disease to Oral Health
8. Study questions hypothermia treatment for cardiac arrest
9. Mayo Clinic-led study: 2 drugs do not improve kidney function in acute heart failure patients
10. New study shows spironolactone reduces heart failure hospitalizations, but not mortality
11. Study reveals potential breakthrough in hearing technology
Post Your Comments:
Related Image:
Study may impact guidelines for mitral valve surgery for severe ischemic mitral regurgitation
(Date:11/24/2015)... , ... November 24, 2015 , ... DMG Productions announced ... Begley Jr., airing first quarter 2016 via Discovery Channel. Dates and show times TBA. ... Province, and is in the business of producing and supplying medical marijuana pursuant to ...
(Date:11/24/2015)... ... November 24, 2015 , ... Preparing for the LDT Regulation:, CLIA Won’t ... , FDA has long asserted that design and manufacture of Laboratory ... tests and do not meet the device regulations. , Come up short in an ...
(Date:11/24/2015)... ... November 24, 2015 , ... The ... waive paid entry and parking fees at several of their most popular properties, ... Great Barrington in support of REI’s Black Friday #OptOutside Campaign. The Trustees encourage ...
(Date:11/24/2015)... Port Richey, FL (PRWEB) , ... November 24, 2015 , ... ... it deems a growing epidemic as deaths from prescription opioids in the United States ... heroin and cocaine. In 2013 alone, opioids were involved in 37 percent of all ...
(Date:11/24/2015)... (PRWEB) , ... November 24, 2015 , ... ... gather to share their knowledge and experiences at a live taping of the ... Ruesch Center for the Cure of Gastrointestinal Cancers 2015 Symposium at Georgetown University ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... November 24, 2015   ... dietician deliver s advice and insights on ... More than 50% of Dubai ... healthy according to the DHA   femMED launches comprehensive solutions ...    Dubai residents are not consuming enough to ...
(Date:11/24/2015)... , Nov. 24, 2015 Abaxis, Inc. (NasdaqGS: ... instruments and consumables for the medical, research, and veterinary ... Chief Financial Officer, will present at the 27 th ... 1, 2015 at 11:30 a.m. ET. The conference will ... New York City . ...
(Date:11/24/2015)... 2015 Edelris announce today that they ... Inserm, Poxel, CNRS, UCBL and ENS-Lyon on a new treatment ... --> Hepatitis B virus (HBV) infection is a major ... infected worldwide, 20 to 40% of them being at risk ... the existence of an effective preventive vaccine, the HBV infection ...
Breaking Medicine Technology: