Multicentre, double-armed, randomized controlled trial designed to compare mitral valve leaflet resection versus leaflet preservation with regards to the development of functional mitral stenosis following surgical repair of mitral valve prolapse. Patients will be randomized (1:1) to receive: (1) mitral valve repair with a leaflet resection or (2) mitral valve repair with leaflet preservation (using polytetrafluoroethylene neochordae), followed by echocardiographic and clinical assessment at 12-months following surgery.
Mitral valve repair has emerged as the preferred surgical treatment for mitral valve prolapse (MVP), a condition wherein the mitral valve does not close properly. One common strategy for mitral valve repair is leaflet resection, which involves removing part of one or both of the mitral leaflets that flop or bulge back (prolapse). Another strategy is leaflet preservation, which involves placing man-made fibers (sutures) to more securely connect the mitral leaflets to the papillary muscles (muscles located in the ventricle). While both strategies are routinely used and lead to successful mitral valve repair, there is no clear evidence as to whether one strategy is better than the other in terms of long term outcome. The purpose of this study is to determine if one repair strategy (leaflet resection versus leaflet preservation) leads to better longer term patient outcomes. A total of 88 patients from 6 Canadian centres will be randomly assigned to one of the two strategies. The primary outcome will be functional mitral stenosis (MS) as assessed by 12-month mean mitral valve pressure gradient at peak exercise.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
104
Placing man-made fibers (sutures) to more securely connect the mitral leaflets to the papillary muscles (muscles located in the ventricle).
Removing one or both of the mitral leaflets that flop or bulge back.
Memorial University
St. John's, Newfoundland and Labrador, Canada
NOT_YET_RECRUITINGHamilton General Hospital
Hamilton, Ontario, Canada
NOT_YET_RECRUITINGLondon Health Sciences Centre
London, Ontario, Canada
Mean mitral valve gradient at peak exercise 12-months following repair
Time frame: 12 months following repair
Mitral valve area
Time frame: 12 months following repair
Age/Sex predicted metabolic equivalent score
Time frame: 12 months following repair
Mitral leaflet coaptation height
Time frame: 12 months following repair
6-minute walk test
Time frame: 12 months following repair
Composite MACE (major adverse cardiovascular event) end-point of recurrent MR ≥2+, death, or hospital re-admission for congestive heart failure within 12-months of surgery
Time frame: 12 months following repair
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University of Ottawa Heart Institute
Ottawa, Ontario, Canada
RECRUITINGSt Michael's Hospital
Toronto, Ontario, Canada
RECRUITINGMcGill University Health Center
Montreal, Quebec, Canada
RECRUITING