Prospective Treatment Algorithm Guiding Repair of Severe Ischemic Mitral Regurgitation
Prospective Treatment Algorithm Guiding Repair of Severe Ischemic Mitral Regurgitation
Ischemic mitral regurgitation is a disease where the mitral valve is regurgitant, or leaking,
 as a result of changes in the muscle of the heart caused by coronary artery disease Ischemic
 mitral regurgitation, or IMR, is normally treated by repairing or replacing the mitral valve.
 Currently, we don't have very strong evidence showing which patients might benefit from
 mitral valve repair and which might benefit from replacement, and surgeons tend to repair or
 replace valves based on their preference or experience. Some surgeons, including Dr. Vincent
 Chan, the Principal Investigator, believe that the decision to repair or replace the valve
 should be based on specific measurements of the mitral valve. This study will randomly assign
 patients to receive either the current standard of care for ischemic mitral regurgitation,
 which is valve repair or replacement based on the surgeon's preference, or to have their
 treatment decided by a set of criteria called an algorithm. This algorithm will assign
 patients with certain mitral valve measurements to repair, and others to replacement.
 Patients will be followed for 12 months after surgery, to compare whether patients whose
 treatment was decided by the algorithm did better than patients whose treatment was decided
 by surgeon preference.
Inclusion Criteria:

 -  Severe ischemic mitral valve regurgitation

 -  18 years of age, and able to provide informed consent.

 Exclusion Criteria:

 -  Mixed mitral valve pathology

 -  Acute ischemic mitral regurgitation