Harold L. Lazar, MD

The addition of a mitral valve repair to patients undergoing coronary artery bypass graft (CABG) surgery with moderate ischemic mitral regurgitation is still a source of controversy. Recent guidelines state that concomitant mitral valve repair at the time of CABG may be beneficial, but the evidence is inconclusive.

Does this study raise more questions than it answers?

Mitral valve replacement provides a greater freedom from recurrent MR in patients with ischemic MR, but does it affect clinical outcomes?

The wide variation in geographic utilization of coronary angiography, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery, despite reimbursement structure, suggests that capitation alone may not lead to reductions in variation.