No benefit to mitral repair with CABG at 2 years
Combining mitral valve repair and coronary artery bypass graft surgery showed no benefit in a study of 301 patients with moderate ischemic mitral regurgitation.
Results from the study, “Two-Year Outcomes of Surgical Treatment of Moderate Ischemic Mitral Regurgitation,” were presented April 3 at ACC 2016 by Dr. Robert Michler of New York CIty’s Montefiore Health System and published in the New England Journal of Medicine.
Two-year mortality was 10% in the CABG/MV repair arm, compared with 10.6% in the CABG-alone group, and there were no differences in major adverse cerebrovascular or cardiovascular events, death, readmissions, functional status or quality of life. Overall rates of hospital readmission and serious adverse events were similar in the two groups, but neurologic events and supraventricular arrhythmias remained more frequent in the combined-procedure group.
“The results of this study suggest there is no significant benefit to what is often considered a routine addition to the open-heart procedure of CABG for patients with moderate IMR,” Michler said in prepared remarks. “However, after 2 years, we did find that the addition of mitral-valve repair provided a more durable correction of mitral regurgitation.”
“The approach to managing patients with moderate ischemic MR at the time of coronary artery bypass grafting remains controversial. The results of this trial study should inform surgical decision making when caring for these complex patients,” added Annetine Gelijns of the Mount Sinai Health System. Read more