Abstract 16962: Two-year Outcomes Following Mitral Valve Repair or Replacement for Severe Ischemic Mitral Regurgitation

Background: The Cardiothoracic Surgical Trials Network recently reported no difference in left ventricular end systolic volume index (LVESVI) at one year post-surgery between patients randomized to mitral repair (n=126) or replacement (n=125) for severe ischemic mitral regurgitation (MR). However, repair patients experienced significantly more recurrent MR than replacement patients. We report the 2-year follow-up of trial participants. Methods: We followed 251 patients randomized to repair or replacement for 2 years. LVESVI was assessed using a Wilcoxon rank sum test in which deaths were assigned the lowest rank. Results: Among surviving patients, mean 2-year LVESVI was 52.6 ±28mL/m2 in the repair and 60.7±39mL/m2 in the replacement arm (mean decrease from baseline 9.0mL/m2 and 6.5mL/m2, respectively). Two-year mortality was 19.1% for repair and 23.2% for replacement (HR 0.79, 95% CI 0.46-1.35; p=0.39). There was no significant between-group difference in LVESVI after adjustment for death (Z=-1.32, p=0.19...