TL;DR: New valve surgery models using contemporary data that include both valve repair as well as replacement are developed, expanding upon existing valve models, and include several nonfatal complications in addition to mortality.
TL;DR: The effectiveness and durability of the central double-orifice technique were assessed and it was found that this type of repair can be a useful addition to the surgical armamentarium in mitral valve reconstruction.
TL;DR: Percutaneous repair with the MitraClip system can be accomplished with low rates of morbidity and mortality and with acute MR reduction to < 2+ in the majority of patients, and with sustained freedom from death, surgery, or recurrent MR in a substantial proportion.
TL;DR: Replacement provided a more durable correction of mitral regurgitation, but there was no significant between-group difference in clinical outcomes.
Abstract: Background Ischemic mitral regurgitation is associated with a substantial risk of death. Practice guidelines recommend surgery for patients with a severe form of this condition but acknowledge that the supporting evidence for repair or replacement is limited. Methods We randomly assigned 251 patients with severe ischemic mitral regurgitation to undergo either mitral-valve repair or chordal-sparing replacement in order to evaluate efficacy and safety. The primary end point was the left ventricular end-systolic volume index (LVESVI) at 12 months, as assessed with the use of a Wilcoxon rank-sum test in which deaths were categorized below the lowest LVESVI rank. Results At 12 months, the mean LVESVI among surviving patients was 54.6±25.0 ml per square meter of body-surface area in the repair group and 60.7±31.5 ml per square meter in the replacement group (mean change from baseline, −6.6 and −6.8 ml per square meter, respectively). The rate of death was 14.3% in the repair group and 17.6% in the replacement g...