الفهرس 
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Abstract
Background: Ischemic mitral regurgitation is associated with a substantial risk of death. Practice guidelines recommend surgery for patients with a moderate to severe form of this condition but acknowledge that the supporting evidence for repair or replacement is limited.
METHODS: We randomly assigned 100 patients with moderate to severe ischemic mitral regurgitation to undergo either mitral-valve repair or replacement in order to evaluate efficacy and safety. The primary end point was the hospital mortality. Secondary end points included ICU course, morbidity and early post-operative echocardiography.
Objectives: Evaluation of the efficacy and safety of mitral valve repair or replacement in patients with ischemic mitral regurgitation.
RESULTS: The rate of death was 12.5% in the repair group and 13.5% in the replacement group. Mortality was associated with the use of IABP, the occurrence of CVS, prolonged ventilation time and high ESDD after surgery. Those 4 variables were introduced in a forwards stepwise logistic regression model to detect independent predictors of mortality. Prolonged ventilation time was independent predictor of mortality. Regarding ICU stay which was 5.42 days in repair group and 4.79 days in replacement group was shorter in replacement group. In early post operative echo there was no significant difference between both groups except for residual MR. In repair group there was 17 patients (35.4%) had no residual MR, 22 patients (45.8%) had grade 1MR, 7 patients (14.5%) had grade 3 MR and 2 patients (4.16%) had grade 3 MR. In replacement group there was no residual MR. There were no significant between-group differences in the rate of morbidity problems as cerebrovascular stroke, renal and liver impairment.
CONCLUSIONS
We observed higher mortality rate in replacement group than repair but there was no statistical difference between both groups. Replacement provided a more durable correction of mitral regurgitation, but there was no significant difference between-groups in clinical outcomes.