Among patients with severe secondary mitral regurgitation, the rate of death or unplanned hospitalization for heart failure at 1 year did not differ significantly between patients who underwent percutaneous mitral-valve repair in addition to receiving medical therapy and those who received medical therapy alone. At 12 months, the rate of the primary outcome was 54.6% (83 of 152 patients) in the intervention group and 51.3% in the control group. We randomly assigned patients who had severe secondary mitral regurgitation, a left ventricular ejection fraction between 15 and 40%, and symptomatic heart failure, in a 1:1 ratio, to undergo percutaneous mitral-valve repair in addition to receiving medical therapy or to receive medical therapy alone.

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