Randomised Ischaemic Mitral Evaluation (RIME) Trial
Randomised Ischaemic Mitral Evaluation (RIME) Trial
The study is a randomised controlled trial comparing two treatment strategies for patients
 with moderate functional ischaemic mitral regurgitation undergoing coronary artery bypass
 grafting (CABG). Patients will be randomised to receive either CABG alone or CABG plus mitral
 annuloplasty. The objective of the study is to determine if mitral annuloplasty in addition
 to CABG improves outcome in patients with moderate functional ischaemic mitral regurgitation.
70 patients with moderate functional ischaemic MR who are undergoing CABG will be recruited.
 Patients will be randomised to undergo either CABG alone or CABG combined with mitral
 annuloplasty. Patients will be investigated at baseline, 3 months and 1 year after surgery to
 determine functional capacity, quality of life, and cardiac function.
Inclusion Criteria:

 1. Patients undergoing CABG.

 2. Patients with moderate functional ischaemic mitral regurgitation without leaflet
 prolapse.

 Exclusion Criteria:

 1. Patients with severe LV dysfunction (EF less than 30%).

 2. Patients with associated significant aortic valve disease.

 3. Patients with significant co-morbidities: renal impairment (creatinine > 160), liver
 impairment (INR > 2.0, bilirubin > 40), or underlying chronic obstructive lung disease
 (FEV1:FVC ratio < 0.6).

 4. Patients with NYHA class IV symptoms, unstable angina, acute pulmonary oedema or
 cardiogenic shock.

 5. Patients unsuitable for surgery e.g. patients with advanced malignancy, unable to give
 informed consent.

 6. Patients with structural abnormalities of the mitral valve e.g. papillary muscle
 rupture, chordal rupture, etc.

 7. Patients with associated conditions which would significantly increase the risk of
 surgery.

 8. Patients who have had previous cardiac surgery.

 9. Patients with a previous history of endocarditis