Two-Year Outcomes of Surgical Treatment of Severe Ischemic Mitral Regurgitation

In this Cardiothoracic Surgical Trials Network (CTSN) trial 251 patients with ischemic mitral regurgitation were randomized to mitral-valve repair or mitral-valve replacement. The current publication reports the 2-year outcomes of the trial.

This trial shows that there was no significant difference in two-year survival between repair and replacement (19.0% vs 23.2%, HR 0.79, 0.46-1.35), although the trial was not powered to study survival. There was no difference in left ventricular end-systolic volume index between the two treatments. Recurring moderate or severe mitral regurgitation was seen more frequently in the repair group (58.8% versus 3.8%, p<0.001), as well as more cardiovascular admissons and heart-failure related adverse events.