@article{ed5c7fcf64ec425c8e9e681dea77024d,
title = "Optimal surgical management of severe ischemic mitral regurgitation: To repair or to replace?",
abstract = "Background: Ischemic mitral regurgitation, a complication of myocardial infarction and coronary artery disease more generally, is associated with a high mortality rate and is estimated to affect 2.8 million Americans. With 1-year mortality rates as high as 40%, recent practice guidelines of professional societies recommend repair or replacement, but there remains a lack of conclusive evidence supporting either intervention. The choice between therapeutic options is characterized by the trade-off between reduced operative morbidity and mortality with repair versus a better long-term correction of mitral insufficiency with replacement. The long-term benefits of repair versus replacement remain unknown, which has led to significant variation in surgical practice. Methods and Results: This article describes the design of a prospective randomized clinical trial to evaluate the safety and effectiveness of mitral valve repair and replacement in patients with severe ischemic mitral regurgitation. This trial is being conducted as part of the Cardiothoracic Surgical Trials Network. This article addresses challenges in selecting a feasible primary end point, characterizing the target population (including the degree of mitral regurgitation) and analytical challenges in this high mortality disease. Conclusions: The article concludes by discussing the importance of information on functional status, survival, neurocognition, quality of life, and cardiac physiology in therapeutic decision making.",
author = "Perrault, {Louis P.} and Moskowitz, {Alan J.} and Kron, {Irving L.} and Acker, {Michael A.} and Miller, {Marissa A.} and Horvath, {Keith A.} and Thourani, {Vinod H.} and Michael Argenziano and D'Alessandro, {David A.} and Blackstone, {Eugene H.} and Moy, {Claudia S.} and Mathew, {Joseph P.} and Judy Hung and Gardner, {Timothy J.} and Parides, {Michael K.}",
note = "Funding Information: National Heart, Lung, and Blood Institute: Marissa A. Miller, Wendy C. Taddei-Peters, Dennis Buxton, Ron Caulder, Nancy L. Geller, David Gordon, Neal O. Jeffries, Albert Lee National Institute of Neurological Disorders and Stroke : Claudia S. Moy Canadian Institutes of Health Research: Ilana Kogan Gombos, Jennifer Ralph Network Chairs: Christiana Care Health System , Timothy J. Gardner (Chair); Brigham and Women{\textquoteright}s Hospital , Patrick T. O{\textquoteright}Gara, (Co-Chair) Data Coordinating Center: International Center for Health Outcomes and Innovation Research (InCHOIR) in the Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY, Annetine C. Gelijns, Michael K. Parides, Deborah D. Ascheim, Alan J. Moskowitz, Ellen Moquete, Eric A. Rose, Melissa Chase, Yingchun Chen, Rosemarie Gagliardi, Alejandra Guerchicoff, Lopa Gupta, Alexander Iribarne, Edlira Kumbarce, Ron Levitan, Karen O{\textquoteright}Sullivan, Mark J. Russo, Milerva Santos, William Slavik, Alan Weinberg, Martin Wells, Paula Williams, Carrie Wood, Xia Ye Core Clinical Site Investigators: Cleveland Clinic Foundation , Eugene H. Blackstone (Principal Investigator [PI]), A. Marc Gillinov, Tomislav Mihaljevic, Richard A. Grimm, Ben Barzilai, Bruce D. Lindsay, Christine Whitman, Denise Kosty Sweeney, Roberta Palumbo; NHLBI Clinical Research Scholars : Gregory Pattakos, Pamela A. Clarke Columbia University Medical Center , Michael Argenziano (PI), Mathew Williams, Lyn Goldsmith, Rebecca T. Hahn, Linda Gillam, Craig R. Smith, Yoshifumi Naka, Allan Stewart, Allan Schwartz Duke University , Peter K. Smith (PI), Stacey Welsh, John H. Alexander, Carmelo A. Milano, Donald D. Glower, Joseph P. Mathew, J. Kevin Harrison; NHLBI Clinical Research Scholars: Mark F. Berry, Cyrus J. Parsa, Betty C. Tong, Judson B. Williams East Carolina Heart Institute , T. Bruce Ferguson (PI), Alan P. Kypson, Evelio Rodriguez, Malissa Harris, Brenda Akers, Allison O{\textquoteright}Neal Emory University , John D. Puskas (PI), Vinod H. Thourani, Robert Guyton, Jefferson Baer, Kim Baio, Alexis Neill Montefiore-Einstein Heart Center, New York, NY , Robert E. Michler (PI), Ricardo Bello, David A. D{\textquoteright}Alessandro, Joseph J. DeRose, Jr, Daniel J. Goldstein, Cynthia Taub, Daniel Spevak, Roger Swayze Montreal Heart Institute , Louis P. Perrault (PI), Ars{\`e}ne-Joseph Basmadjian, Denis Bouchard, Michel Carrier, Philippe Demers, Michel Pellerin, Sophie Robichaud NIH Heart Center at Suburban Hospital , Keith A. Horvath (PI), Philip C. Corcoran, Michael P. Siegenthaler, Mandy Murphy, Margaret Iraola, Ann Greenberg University of Pennsylvania , Michael A. Acker (PI), Y. Joseph Woo, Wilson Y. Szeto, Mary Lou Mayer University of Virginia , Irving L. Kron (PI), Gorav Ailawadi, Karen Johnston, John M. Dent, Sandra Burks, Kim Gahring ",
year = "2012",
month = jun,
doi = "10.1016/j.jtcvs.2011.05.030",
language = "English (US)",
volume = "143",
pages = "1396--1403",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "6",
}