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Mitral Valve Repair Following Heart Attack May Offer Patients Little To No Benefit


National Institutes of Health (NIH)

November 18, 2014

What

Routinely adding mitral valve repair to coronary artery bypass graft surgery for heart attack patients may not be warranted in patients with moderate mitral valve damage, according to an NIH-funded study. Patients treated with both procedures versus the bypass graft alone showed no differences at one year in recovery from structural damage to the heart's left ventricle, nor in secondary measures such as heart failure, stroke, functional status or quality of life.
The results of the Surgical Interventions for Moderate Ischemic Mitral Regurgitation (IMR) study, supported by NIH's National Heart, Lung, and Blood Institute (NHLBI), were presented today at the American Heart Association Scientific Sessions in Chicago and published simultaneously in the New England Journal of Medicine.
About one million Americans suffer heart attacks each year. Of these, about half are left with functional damage to the mitral valve due to the injury and changes to the heart muscle. This damage can result in leaks, causing a backflow of blood accompanied by symptoms such as shortness of breath, abnormal fatigue, and excess blood in the lungs.
Doctors typically treat heart attack patients with this condition, called ischemic mitral regurgitation, by performing coronary artery bypass graft surgery, sometimes adding a procedure to repair the leaky mitral valve. The study is the first large-scale randomized clinical trial to assess whether adding the repair procedure leads to a measurable benefit for patients.
The study included 301 patients with moderate IMR who had been treated with one or both surgical procedures. Researchers assessed each patient's condition at six and 12 months by measuring the amount of blood remaining in the left ventricle after a heart contraction. Both patient groups showed similar rates of improvement at the 12-month assessment.
This research was conducted as part of NHLBI's Cardiothoracic Surgical Trials Network and was co-funded by the National Institute for Neurological Diseases and Stroke and the Canadian Institutes for Health Research.

Who

Marissa A. Miller, DVM, MPH, Chief of the Advanced Technologies and Surgery Branch/Division of Cardiovascular Sciences at the NHLBI
Contact
For more information or to schedule an interview with Dr. Miller, please contact the NHLBI Communications Office at 301-496-4236 or nhlbi_news@nhlbi.nih.gov.
The National Heart, Lung, and Blood Institute (NHLBI) is a component of the National Institutes of Health. NHLBI plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at http://www.nhlbi.nih.gov
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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