The mitral valve is a “gateway” in the left chamber of the heart that ensures normal physiological circulation. Mitral valve prolapse is a disease where the mitral valve flaps become weak, and do not close properly. As a result of mitral valve dysfunction, blood can leak backwards from the lower chamber into the upper chamber, leading to mitral regurgitation. Although mitral valve prolapse can be repaired by surgery, there is limited clinical trial evidence on which technique is superior in terms of safety, outcome, other surgical metrics, and post-operative quality of life to guide cardiac surgeons in the decision-making process when selecting a repair strategy. Evidence to date supports mitral valve repair as the preferred option over mitral valve replacement. Leaflet resection and leaflet preservation are the two surgical repair strategies and CAMRA demonstrated that both had similar risk of functional mitral stenosis thus offering important evidence-based insights and reassurance that one approach was not necessarily superior to the other. The CAMRA CardioLink-2 discoveries were presented at a Late-Breaking trial session of the 2020 European Society of Cardiology (ESC) Congress and published in
Circulation in 2020Primary Publication
Chan V, Mazer CD, Ali FM, Quan A, Ruel M, de Varennes BE, Gregory AJ, Bouchard D, Whitlock RP, Chu MWA, Dokollari A, Mesana T, Bhatt DL, Latter DA, Zuo F, Tsang W, Teoh H, Jüni P, Leong-Poi H, Verma S. Randomized controlled trial comparing mitral valve repair with leaflet resection versus leaflet preservation on functional mitral stenosis: The CAMRA CardioLink-2 study. Circulation. 2020 Oct6;142(14):1342-1350.
View details on PubMedSecondary Publications
Hibino M, Dhingra NK, Verma S, Chan V, Quan A, Gregory AJ, Chu MWA, Ong G, Teoh H, Mazer CD, Tsang W, Messika-Zeitoun D, Leong-Poi H, Connelly KA; CAMRA Trial CardioLink-2 Collaborators. Mitral repair with leaflet preservation versus leaflet resection and ventricular reverse remodeling from a randomized trial. J Thorac Cardiovasc Surg. 2023 Jul;166(1):74-83.
View details on PubMedRumman RK, Verma S, Chan V, Mazer CD, Quan A, Hibino M, de Varennes BE, Chu MWA, Latter DA, Teoh H, Yanagawa B, Leong-Poi H, Connelly KA. Predictors of mitral valve haemodynamics after mitral valve repair for degenerative mitral regurgitation. Heart 2023;109:866–873.
View details on PubMedHibino M, Pandey A, Chan V, Mazer CD, Rumman R, Dhingra NK, Bonneau C, Verma R, Yokoyama Y, Quan A, Teoh H, Cheema A, de Varennes BE, Yanagawa B, Leong-Poi H, Connelly KA, Bisleri G, Verma S. Risk Factors for Post-Repair Elevated Mitral Gradient: A Post-Hoc Analysis of a Randomized Trial. Ann Thorac Surg. 2023 Feb;115(2):437-443.
View details on PubMedHibino M, Dhingra NK, Chan V, Mazer CD, Teoh H, Quan A, Verma R, Leong-Poi H, Bisleri G, Connelly KA, Verma S. Stage-Based Approach to Predict Left Ventricular Reverse Remodeling After Mitral Repair. Clin Cardiol. 2022 Sep;45(9):921-927.
View details on PubMedHibino M, Pandey A, Chan V, Mazer CD, Dhingra NK, Bonneau C, Verma R, Quan A, Teoh H, Cheema A, Yanagawa B, Leong-Poi H, Connelly KA, Bisleri G, Verma S. Leaflet Resection vs Preservation for Degenerative Mitral Regurgitation: Functional Outcomes and Mitral Stenosis at 12 months in a Randomized Trial. Can J Cardiol. 2022 Jun;38(6):808-814.
View details on PubMedChan V, Chu MWA, Leong-Poi H, Latter DA, Hall J, Thorpe KE, de Varennes BE, Quan A, Tsang W, Dhingra N, Yared K, Teoh H, Chu FV, Chan K-L, Mesana TG, Connelly KA, Ruel M, Jüni P, Mazer CD, Verma S. Randomised trial of mitral valve repair with leaflet resection versus leaflet preservation on functional mitral stenosis (The CAMRA CardioLink-2 Trial). BMJ Open. 2017 May 30;7(5):e015032.
View details on PubMedPeer-reviewed funding received from:
- Heart & Stroke Foundation of Canada
