6/28/23, 11:16 PM MIDA Pathway Feedback Search Clinical Topics Home Studies MIDA MIDA Disease Mitral regurgitation Trial question What is the role of early surgical intervention in patients with flail mitral valve regurgitation? Study design Multi-center Open label Observational study Population Characteristics of study participants 27.1% female N = 2097 72.9% male 2097 patients (278 female, 743 male) Inclusion criteria: patients with mitral valve regurgitation due to flail mitral leaflets Key exclusion criteria: current HF symptoms, LVEF < 60%, LV end-systolic diameter 40 mm, or contraindication to surgery due to comorbidity Interventions N=446 early mitral surgery (performed within 3 months from diagnosis) N=575 initial medical management (during the first 3 months of follow-up then either medical or surgical treatment thereafter) Primary outcome Survival at 10 years https://web.pathway.md/studies/recLT7XHRC0H0hZCF 1/2 6/28/23, 11:16 PM MIDA Pathway 86.0 % 86 69 64.5 % 43.0 % Significant increase 21.5 % NNT = 6 0.0 % Early mitral surgery Initial medical management Significant increase in survival at 10 years (86% vs. 69%; HR 1.81, 95% CI 1.38 to 2.43) Secondary outcomes Significant decrease in long-term HF risk, at 10 years (7% vs. 23%; HR 0.29, 95% CI 0.19 to 0.43) No significant difference in death at 3 months (1.1% vs. 0.5%; RR 2.2, 95% CI -1.76 to 6.16) Conclusion In patients with mitral valve regurgitation due to flail mitral leaflets, early mitral surgery was superior to initial medical management with respect to survival at 10 years. Reference Suri RM, Vanoverschelde JL, Grigioni F et al. Association between early surgical intervention vs watchful waiting and outcomes for mitral regurgitation due to flail mitral valve leaflets. JAMA. 2013 Aug 14;310(6):609-16. Open reference URL https://web.pathway.md/studies/recLT7XHRC0H0hZCF 2/2