Surgery is thought to be life-saving for people who have ischemic mitral regurgitation, but it is unknown whether surgical repair or surgical replacement of the mitral valve is the better procedure. Repair is thought to result in fewer preoperative deaths and replacement is thought to have better long-term outcomes with a reduced incidence of recurrent mitral regurgitation. In recent years, many surgeons have grown to favor repair. Currently about two-thirds of patients in the US undergo a repair operation.
In a trial presented at the American Heart Association meeting in Dallas and published simultaneously in the New England Journal of Medicine, members of the Cardiothoracic Surgical Trials Network randomized 251 patients with severe ischemic mitral regurgitation to either repair or replacement.
At one year there was no difference in the primary end point, left ventricular end-systolic volume index, between the two groups.