The Canadian Mitral Research Alliance (CAMRA-1) Trial

2015-09-18 04:08:24 | BioPortfolio


Multicentre, double-armed, randomized controlled trial designed to compare mitral valve leaflet resection versus leaflet preservation with regards to the development of functional mitral stenosis following surgical repair of mitral valve prolapse. Patients will be randomized (1:1) to receive: (1) mitral valve repair with a leaflet resection or (2) mitral valve repair with leaflet preservation (using polytetrafluoroethylene neochordae), followed by echocardiographic and clinical assessment at 12-months following surgery.


Mitral valve repair has emerged as the preferred surgical treatment for mitral valve prolapse (MVP), a condition wherein the mitral valve does not close properly. One common strategy for mitral valve repair is leaflet resection, which involves removing part of one or both of the mitral leaflets that flop or bulge back (prolapse). Another strategy is leaflet preservation, which involves placing man-made fibers (sutures) to more securely connect the mitral leaflets to the papillary muscles (muscles located in the ventricle). While both strategies are routinely used and lead to successful mitral valve repair, there is no clear evidence as to whether one strategy is better than the other in terms of long term outcome. The purpose of this study is to determine if one repair strategy (leaflet resection versus leaflet preservation) leads to better longer term patient outcomes. A total of 88 patients from 3 Canadian centres will be randomly assigned to one of the two strategies. The primary outcome will be functional mitral stenosis (MS) as assessed by 12-month mean mitral valve pressure gradient at peak exercise.

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment


Mitral Valve Prolapse


Mitral repair with leaflet preservation, Mitral repair with leaflet resection


London Health Sciences Centre
N6A 5W9


Not yet recruiting


St. Michael's Hospital, Toronto

Results (where available)

View Results


Published on BioPortfolio: 2015-09-18T04:08:24-0400

Clinical Trials [1958 Associated Clinical Trials listed on BioPortfolio]

Observational Study of the Heart Repair Technologies Mitral Bridge in Treating Mitral Valve Regurgitation

Prospective, observational, multi-center trial in which patients with mitral regurgitation sufficient to merit mitral valve repair will receive a surgical transvalvular, intra-annular Mitr...

Early Mitral ValvE Repair Versus Watchful Waiting for Asymptomatic SEvere Degenerative Mitral Regurgitation

Degenerative mitral regurgitation (MR) due to leaflet prolapse is frequent and can be surgically repaired in the vast majority of patients. Despite the efficacy of mitral valve repair, an ...

Coronary and Structural Interventions Ulm - Transcatheter Mitral Valve Repair (CSI-Ulm-TMVR)

To evaluate the long-term results after transcatheter mitral valve repair

Comparing the Effectiveness of Repairing Versus Replacing the Heart's Mitral Valve in People With Severe Chronic Ischemic Mitral Regurgitation

People with coronary artery disease (CAD) or people who have had a heart attack may develop a leak in the mitral valve of their heart and may therefore need to undergo surgery to fix the v...

Should we Repair Ischemic Mitral Regurgitation?

The purpose of this study is to assess whether adding mitral valve repair to coronary artery bypass grafting improves outcome in patients with ischemic mitral regurgitation.

PubMed Articles [3420 Associated PubMed Articles listed on BioPortfolio]

Functional and Degenerative Mitral Regurgitation: One Ring Fits All?

 Three-dimensional saddle-shaped annuloplasty rings have been shown to create a larger surface of leaflet coaptation in mitral valve repair (MVR) for functional mitral regurgitation (FMR) and degene...

Percutaneous Approaches to the Treatment of Mitral Leaflet Perforation and to Residual Regurgitation After Transcatheter Edge-to-Edge Mitral Valve Repair.

Mitral valve disease becomes more prevalent as the population ages. As the number of percutaneous mitral valve interventions expands, obscure clinical scenarios may emerge and challenge conventional t...

Midterm results of Mitral Valve Repair with Pericardial leaflet augmentation: A Single center experience.

In certain pathologies, mitral valve repair is complicated by a paucity of tissue caused by fibrosis or destruction. Utilization of autologous pericardium for leaflet augmentation may be the only opti...

Choosing the "Best" surgical techniques for mitral valve repair: Lessons from the literature.

Mitral valve (MV) repair is the procedure of choice to correct mitral regurgitation caused by degenerative MV disease, due to its well-documented superiority over MV replacement. Repair of the MV is f...

Operator Experience and Procedural Results of Transcatheter Mitral Valve Repair in the United States.

Transcatheter mitral valve repair (TMVr) for the treatment of mitral regurgitation (MR) is a complex procedure that requires development of a unique skillset.

Medical and Biotech [MESH] Definitions

A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annulus of the MITRAL VALVE. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs.

Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.

Abnormal protrusion or billowing of one or both of the leaflets of MITRAL VALVE into the LEFT ATRIUM during SYSTOLE. This allows the backflow of blood into left atrium leading to MITRAL VALVE INSUFFICIENCY; SYSTOLIC MURMURS; or CARDIAC ARRHYTHMIA.

The reconstruction of a continuous two-stranded DNA molecule without mismatch from a molecule which contained damaged regions. The major repair mechanisms are excision repair, in which defective regions in one strand are excised and resynthesized using the complementary base pairing information in the intact strand; photoreactivation repair, in which the lethal and mutagenic effects of ultraviolet light are eliminated; and post-replication repair, in which the primary lesions are not repaired, but the gaps in one daughter duplex are filled in by incorporation of portions of the other (undamaged) daughter duplex. Excision repair and post-replication repair are sometimes referred to as "dark repair" because they do not require light.

Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.

More From BioPortfolio on "The Canadian Mitral Research Alliance (CAMRA-1) Trial"

Quick Search

Relevant Topic

Surgical treatments
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...

Searches Linking to this Trial