Moderate mitral regurgitation in patients undergoing CABG--the MoMIC trial.
BACKGROUND
The presence of mild to moderate ischemic mitral regurgitation (IMR) marks a significantly reduced long-term survival and increased hospitalizations due to heart-failure. However, it is common practice in many institutions to refrain from repairing the mitral valve in these patients. There are no available conclusive data to support this practice, and thus there is a need for an adequately powered randomized trial.


METHODS
The Moderate Mitral Regurgitation In Patients Undergoing CABG (MoMIC) trial is the first international multi-center, large-scale study to clarify whether moderate IMR in CABG patients should be corrected. A total of 550 CABG patients with moderate IMR are to be randomized to treatment of either CABG alone or CABG plus mitral valve correction. The primary end point is a composite end point of mortality and rehospitalization for heart failure at five years. The inclusion and randomization of patients started in February 2008.


CONCLUSIONS
If correction of moderate IMR in CABG patients proves to be the superior strategy, most patients should be treated accordingly.
Department of Cardiothoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark. pwi@sks.aaa.dk
Per
P
Wierup
Henrik
H
Egeblad
Sten Lyager
SL
Nielsen
Henrik
H
Scherstén
Per-Ola
PO
Kimblad
Odd
O
Bech-Hansen
Anders
A
Roijer
Folke
F
Nilsson
Patrick M
PM
McCarthy
Denis
D
Bouchard
Jacob
J
Jacobsen
Søren Paaske
SP
Johnsen
Steen Hvitfeldt
SH
Poulsen
Henning
H
Mølgaard
D019917:Blood Vessel Prosthesis Implantation; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017202:Myocardial Ischemia / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D009656:North America; D012107:Research Design; D012537:Scandinavian and Nordic Countries; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome