Randomised Ischaemic Mitral Evaluation (RIME) Trial

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