• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

No benefit of adding mitral valve repair to CABG

byAndrew Cheung, MD MBA
November 19, 2014
in Cardiology, Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. In patients with multivessel coronary artery disease and moderate mitral regurgitation, there was no significant benefit on left ventricular reverse remodeling at 12 months with performing mitral valve repair with coronary artery bypass grafting, when compared with bypass surgery alone.

2. There was no significant difference between the two groups in the rate of major cardiac and cerebrovascular events.

3. Patients undergoing the combined surgery experienced higher rates of neurologic adverse events and lengthier hospital and intensive care stays than those undergoing bypass alone.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Ischemic mitral regurgitation is a common complication of ischemic heart disease, and mitral regurgitation has been linked with increased risk of mortality in these patients. Although it is understood that ischemic mitral regurgitation has been associated with higher risk of adverse outcomes in patients undergoing coronary artery bypass grafting (CABG), it is unknown if performing concurrent mitral valve repair offers any benefits. This study randomized patients with multivessel coronary artery disease and moderate ischemic mitral valve regurgitation to receive either CABG with mitral valve repair or CABG-alone. In summary, there was no significant difference between the two groups in the degree of left ventricular reverse remodeling at the 12 month mark. Moreover, there were no significant differences between the two groups in mortality or the rate of major cardiac/cerebrovascular events. Patients undergoing the combined procedure experienced significantly higher rates of neurologic adverse events and lengthier hospitalizations after surgery than those undergoing CABG-alone. Thus, this trial suggests that there is no clinical advantage of adding mitral valve repair in patients with moderate ischemic mitral regurgitation undergoing CABG for multivessel coronary artery disease. Longer term follow-up in this study is ongoing.

Click to read the study in NEJM

Relevant Reading: Coronary artery bypass surgery with or without mitral valve annuloplasty in moderate functional ischemic mitral regurgitation: Final results of the Randomized Ischemic Mitral Evaluation (RIME) trial

RELATED REPORTS

Coronary artery bypass grafting reduces rate of myocardial infarctions compared to percutaneous coronary intervention for left main coronary artery disease

#VisualAbstract: Drug-eluting stents for saphenous vein grafts associated with better outcomes than bare-metal stents

#VisualAbstract: Randomized Trial of Endoscopic or Open Vein-Graft Harvesting for Coronary-Artery Bypass

In-Depth [randomized controlled trial]: A total of 301 patients from 26 sites in Canada and the United States were randomized as part of this study. All adults with multivessel coronary artery disease and moderate ischemic mitral valve regurgitation were considered eligible for this study. The severity of the mitral regurgitation was determined using transthoracic echocardiography. Intraoperatively, transesophageal echocardiography was performed to confirm the absence of mitral valve structural abnormality, and eligible patients were subsequently randomized to receive either CABG with mitral valve repair (i.e., combined procedure) or CABG alone. The primary endpoint was the degree of left ventricular reverse remodeling at the 12-month mark as determined by the left ventricular end-systolic volume index (LVESVI) measured through transthoracic echocardiography. Secondary endpoints included a composite of major cardiac/cerebrovascular events (i.e., death, stroke, subsequent mitral valve surgery, hospitalization for heart failure, increase in New York Heart Association classification) and mortality.

The duration of aortic cross-clamping (p<0.001) and cardiopulmonary bypass (p<0.001) were significantly higher in patients undergoing CABG with mitral valve repair. The mean change in LVESVI from baseline were similar in patients undergoing CABG-alone and the combined procedure (-9.4 mL/m2 and -9.3 mL/m2, respectively). There was no significant difference between the two groups in the rate of mortality (HR 0.90; 95%CI 0.38-2.12). Moreover, there was no significant difference between the two groups in the rate of major cardiac/cerebrovascular events (HR 0.99; 95%CI 0.62-1.59) or any of the individual components of the composite score. Patients who underwent the combined procedure experienced significantly higher rates of neurologic adverse events (e.g., stroke, transient ischemic attack, metabolic encephalopathy) than those undergoing CABG-alone (p=0.03). Patients undergoing CABG-alone also had shorter stays after surgery (p=0.002) and in the intensive care unit (p=0.006) compared to those who had the combined procedure.

Image: PD

©2014 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. No article should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2 Minute Medicine, Inc.

Tags: CABGmitral valve replacement
Previous Post

Extended dual antiplatelet therapy after DES reduces risk of thrombosis [DAPT trial]

Next Post

Genetically engineered lymphocytes inhibit Hepatitis C virus replication in vitro [PreClinical]

RelatedReports

Cognitive outcomes in older adults undergoing cardiovascular procedures unclear
Cardiology

Coronary artery bypass grafting reduces rate of myocardial infarctions compared to percutaneous coronary intervention for left main coronary artery disease

January 20, 2022
#VisualAbstract: Drug-eluting stents for saphenous vein grafts associated with better outcomes than bare-metal stents
StudyGraphics

#VisualAbstract: Drug-eluting stents for saphenous vein grafts associated with better outcomes than bare-metal stents

October 28, 2020
#VisualAbstract: Randomized Trial of Endoscopic or Open Vein-Graft Harvesting for Coronary-Artery Bypass
StudyGraphics

#VisualAbstract: Randomized Trial of Endoscopic or Open Vein-Graft Harvesting for Coronary-Artery Bypass

September 6, 2020
Cognitive outcomes in older adults undergoing cardiovascular procedures unclear
Cardiology

The REGROUP trial: endoscopic and open vein-graft harvest associated with similar outcomes

January 13, 2019
Next Post
New hepatitis C virus (HCV) treatment effective

Genetically engineered lymphocytes inhibit Hepatitis C virus replication in vitro [PreClinical]

Preterm birth associated with elevated plasma insulin levels

Increased mortality observed in type 1 diabetes

Early tube feeding unable to reduce infections in pancreatitis [PYTHON trial]

Early tube feeding unable to reduce infections in pancreatitis [PYTHON trial]

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Same appointment mammogram results may result in less stress for patients being screened for breast cancer
  • Increased use of pediatric CT poses significant oncogenic risk [Classics Series]
  • Pediatric asthma morbidity is associated with geographic location and social determinants of health
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.