Key result
Adding mitral-valve repair to CABG fails to improve LV reverse remodeling in moderate ischemic MR.
Why the study?
Does the addition of mitral-valve repair to CABG improve left ventricular reverse remodeling and survival compared to CABG alone in patients with moderate ischemic mitral regurgitation?
RCT (n=301)
randomly assigned
Does the addition of mitral-valve repair to CABG improve left ventricular reverse remodeling and survival compared to CABG alone in patients with moderate ischemic mitral regurgitation?
Effect estimate: z score 0.38
Absolute Event Rate: 43.2% vs 41.2%
p-value: p=0.71
In patients with moderate ischemic mitral regurgitation, adding mitral-valve repair to CABG does not significantly improve left ventricular reverse remodeling or survival at 2 years, but increases the risk of neurologic events and supraventricular arrhythmias.
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Supports CABG alone for moderate ischemic MR; challenges routine addition of mitral repair.
Goldstein et al. (2015) conducted an RCT in moderate ischemic mitral regurgitation (n=301). CABG plus mitral-valve repair vs. CABG alone was evaluated on left ventricular end-systolic volume index (LVESVI) in ml/m2 (z score 0.38, p=0.71). Adding mitral-valve repair to CABG in patients with moderate ischemic mitral regurgitation did not significantly improve left ventricular reverse remodeling at 2 years (z score 0.38; P=0.71).
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