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At 59 months (interquartile range, 37\u201385 months) follow-up, though the left ventricle end-diastolic diameter was markedly larger (<jats:italic>P<\/jats:italic>\u2009=\u20090.019) in the MVA group than in the MVR group, no significant difference was observed in overall survival, freedom from cardiac death, or avoidance of major adverse cardiac or cerebrovascular events (MACCE). MVA provides better results in freedom from cardiac death in subgroups of age \u226565years and left ventricular ejection fraction (EF) \u226550% (<jats:italic>P<\/jats:italic>\u2009=\u20090.014 and <jats:italic>P<\/jats:italic>\u2009=\u20090.016, respectively), whereas MVR was associated with a lower risk of MACCE in subgroups of age &lt;65years, EF &lt;50% and left ventricular inferior basal wall motion abnormality (BWMA) (all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). In conclusion, MVR is a suitable management of patients with severe CIMR, and it is more favorable to ventricular remodeling. The choice of MVA or MVR should depend on major high-risk clinical factors.<\/jats:p>","DOI":"10.1038\/s41598-018-19909-7","type":"journal-article","created":{"date-parts":[[2018,1,18]],"date-time":"2018-01-18T13:04:09Z","timestamp":1516280649000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Mitral valve annuloplasty versus replacement for severe ischemic mitral regurgitation"],"prefix":"10.1038","volume":"8","author":[{"given":"Baotong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanglin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhu","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuiyun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,1,24]]},"reference":[{"key":"19909_CR1","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1056\/NEJMoa1312808","volume":"370","author":"MA Acker","year":"2014","unstructured":"Acker, M. 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