Key result
Mitral valve repair showed similar MACCE-free survival to replacement (HR 1.41; 95% CI 0.57-3.44; P=0.455) but was associated with an increased risk of recurrent mitral regurgitation (P=0.041).
Why the study?
Clinical guidelines recommend chordal-sparing mitral valve replacement over repair for severe IMR during CABG, but no similar recommendations exist for patients undergoing LVR.
Does mitral valve repair compared to mitral valve replacement improve MACCE-free survival in patients undergoing left ventricular reconstruction with more than moderate ischemic mitral regurgitation?
Population
74 consecutive patients undergoing LVR and mitral valve surgery
Comparison
Mitral valve repair vs mitral valve replacement
Design
Single-center retrospective cohort study
Follow-up
Median 59.4 months
Authors
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Comparable survival supports either mitral approach with LVR plus IMR; leaves open whether replacement better prevents recurrent regurgitation.
Cohort (n=74)
No
Does mitral valve repair compared to mitral valve replacement improve MACCE-free survival in patients undergoing left ventricular reconstruction with more than moderate ischemic mitral regurgitation?
Hazard Ratio: 1.41 (95% CI 0.57–3.44)
p-value: p=0.455
In patients undergoing left ventricular reconstruction with more than moderate ischemic mitral regurgitation, mitral valve replacement offers comparable survival to repair but may provide better durable correction of mitral regurgitation.
Tiemuerniyazi et al. (2022) conducted a cohort in More than moderate ischemic mitral regurgitation in patients undergoing left ventricular reconstruction (n=74). Mitral valve repair vs. Mitral valve replacement was evaluated on Survival free of major adverse cardiovascular and cerebrovascular events (MACCE) (HR 1.41, 95% CI 0.57-3.44, p=0.455). Mitral valve repair showed similar MACCE-free survival to replacement (HR 1.41; 95% CI 0.57-3.44; P=0.455) but was associated with an increased risk of recurrent mitral regurgitation (P=0.041).
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