Functional, ischemic mitral regurgitation: to repair or not to repair?

With an ever increasing population of patients with coronary artery disease complicated by chronic ischemic mitral regurgitation (IMR), the question of whether to perform mitral valve repair (MVRep) in addition to coronary artery bypass grafting (CABG) is one of the most common and controversial clinical dilemmas faced by cardiac surgeons today. At present, there is no definitive randomized, prospective trial that clarifies exactly what approach should be taken.