Biological versus prosthetic ring in mitral-valve repair: Enhancement of mitral annulus dynamics and left-ventricular function with pericardial annuloplasty at long term

Valentino Borghetti, Marco Campana, Carla Scotti, Diego Domenighini, Pasquale Totaro, Giuseppe Coletti, Marco Pagani, Roberto Lorusso

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The effects of different annuloplasty rings on mitral annulus dynamics and left-ventricular (LV) function after mitral-valve repair (MVR) are still controversial. This study sought to compare biological versus prosthetic rigid rings for annular remodelling in MVR at long term. Methods: Forty-four consecutive patients were retrospectively enrolled. All patients had isolated posterior-leaflet prolapse and underwent identical surgical mitral-valve reconstruction (quadrangular resection of the posterior leaflet associated with annuloplasty). Twenty-three patients underwent mitral annuloplasty with an autologous pericardial ring (group I), whereas 21 patients had MVR with a Carpentier-Edwards rigid ring (group II). No differences existed between the groups in terms of pre-operative patient profile. Post-operative LV systolic indices have been assessed by two-dimensional echocardiography at rest and during supine bicycle exercise. Mitral annular motion has been examined by means of the extent of mitral annulus systolic excursion (MASE), as measured in four longitudinal LV segments (anterior, inferior, septal and lateral). Mean and peak trans-mitral flow velocities (TMFV) have been also evaluated by continuous-wave Doppler. Results: The mean follow-up did not differ between the groups, those being 41±12 months in group I (range17-65 months) and 46±15 months in group II (range 23-83 months), respectively. Post-operative echocardiographic study did not show significant mitral regurgitation at rest or at peak exercise in any patient. ANOVA analysis for repeated measures showed a significant interaction in peak TMFV (F((1,42))=5.23; P=0.03), and in left-ventricular ejection fraction (LVEF; F((1,42))=7.61, P=0.01). The analysis of contrasts showed a significant increase in TMFV in both groups (group I from 1.22±0.22 to 1.79±0.32 m/s, t=-8.8, P

Original languageEnglish
Pages (from-to)431-439
Number of pages9
JournalEuropean Journal of Cardio-thoracic Surgery
Volume17
Issue number4
DOIs
Publication statusPublished - Apr 1 2000

Keywords

  • Mitral annulus dynamics
  • Mitral-valve repair
  • Pericardial annuloplasty

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Fingerprint

Dive into the research topics of 'Biological versus prosthetic ring in mitral-valve repair: Enhancement of mitral annulus dynamics and left-ventricular function with pericardial annuloplasty at long term'. Together they form a unique fingerprint.

Cite this