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Objective: The aim of this study was to determine the prevalence of moderate ischemic mitral regurgitation (IMR) in the contemporary CABG population. We also aimed to correlate the effective regurgitant orifice area (ERO) of any regurgitant mitral valve in patients with coronary artery disease with the semiquantitative integrated scale of IMR. Design: From March 15 through June 15, 2006, 510 consecutive CABG patients in three tertiary centres were included in the study. All patients showing any sign of mitral regurgitation (MR) at the referring hospital underwent a preoperative transthoracic echocardiographic estimation of the degree of MR using the integrated scale (1-4) and ERO. Results: IMR was found in 141 patients (28%). The prevalence of moderate 2+ or worse IMR was 4% (95% CI; 2.5-6.1%) and the ERO corresponding to 2+ IMR or more ranged from 5 to 30 mm(2). Fourteen patients had an ERO between 15-30 mm(2). Conclusions: According to our study, patients with moderate IMR, defined as an ERO between 15-30 mm(2), account for only 2.7% (95% CI; 1.5-4.7%) of a non-emergency CABG population. [ABSTRACT FROM AUTHOR]

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., Study Design: 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., Implication: If correction of moderate IMR in CABG patients proves to be the superior strategy, most patients should be treated accordingly.

Objective: The 20-year data from the ongoing long-term study of the St Jude Medical Biocor (St Jude Medical, St Paul, Minn) porcine bioprosthesis are reported. Earlier follow-ups have shown that the valve has excellent durability. After 20 years, will this continue to be true?, Methods: Data were obtained for 1712 patients who underwent valve replacement (1518 aortic valve replacements; 194 mitral valve replacements) with glutaraldehyde-preserved Biocor bioprostheses at Sahlgrenska University Hospital (Sweden) between 1983 and 2003. Follow-up after surgery was evaluated on alternate years using hospital records, interviews, and questionnaires., Results: At 20 years, the cumulative follow-up was 8843 and 1195 patient-years for aortic valve replacement and mitral valve replacement, respectively. Survival after aortic valve replacement was 17.7% +/- 3.3%, and survival after mitral valve replacement was 16.4% +/- 4.7%. Actuarial freedom from reoperation because of structural valve deterioration was 61.1% +/- 8.5% and 79.3% +/- 6.0% after aortic valve replacement and mitral valve replacement, respectively. (The equivalent actual/cumulative values were 85.6% +/- 2.2% and 91.2% +/- 2.6%, respectively.) In aortic valve recipients aged 65 years or less and more than 65 years, actuarial freedom from reoperation because of structural valve deterioration was 44.5% +/- 9.2% and 92.1% +/- 3.9%, respectively. The equivalent values in mitral valve recipients were 75.2% +/- 7.6% and 88.0% +/- 8.1%, respectively., Conclusion: The 20-year data confirm the excellent valve durability reported at the 17-year follow-up after both aortic valve replacement and mitral valve replacement using the Biocor porcine bioprosthesis.