Operative Details and Hospital Outcomes
Operative details are presented in Table 2 . Most patients (93%) had concomitant CABG, and 4% underwent concomitant tricuspid valve surgery. In the replacement group, 72% of the patients had chordal preservation. In the repair group, a rigid or semirigid ring was used to achieve a downsizing annuloplasty. Patients who underwent MVR had longer cardiopulmonary bypass (CPB) and cross-clamp times (p < 0.0001). Hospital outcomes are summarized in Table 3 . Patients who underwent MV replacement had a higher rate of LCOS with an increased requirement for inotropic (p = 0.01) and IABP support (p < 0.0001). These differences were associated with significantly higher unadjusted mortality in the MV replacement cohort.