Technology and health care : official journal of the European Society for Engineering and Medicine · 2016
Dynamic mitral annular motion after posterior mitral annuloplasty: Use of a strip that is designed for placement in the posterior annulus.
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Zhang Ren Wen, Choi Jong Bum, Kuh Ja Hong
Аннотация
BACKGROUND: Most annuloplasty rings and bands used for mitral valve repair restrict annular motion due to their fixation to the posterior annulus, the commissures, and the trigones.
OBJECTIVE: Annular motion was evaluated after posterior mitral annuloplasty (PMA) for correction of mitral valve regurgitation (MR) using a strip that is designed for placement in the posterior annulus only, sparing the anterior annulus and both commissural angles.
METHODS: Valve annular dynamics were analyzed in 51 patients who underwent PMA for MR. In 37 patients (72.5%), additional associated procedures were performed: new chord placement (n = 35), patch valvuloplasty (n = 4), and posterior leaflet augmentation (n = 12). Patients received serial echocardiographic follow-up.
RESULTS: After PMA, the MR grade was nil or mild (0 and 1+) in 47 patients (92.1%), moderate (2+) in 3 patients (5.9%), and moderate to severe (3+) in 1 patient (2.0%). The maximum and minimum septo-lateral dimensions during the cardiac cycle were 21.7 ± 4.8 mm and 18.1 ± 4.1 mm (p < 0.0001), respectively, and the change ratios were 19.8 ± 9.3%. While the septo-lateral dimensions exhibited dynamic changes, the aorto-mitral dimensions remained constant throughout the cardiac cycle.
CONCLUSIONS: PMA preserves dynamic septo-lateral motion of the mitral valve annulus during the cardiac cycle.
OBJECTIVE: Annular motion was evaluated after posterior mitral annuloplasty (PMA) for correction of mitral valve regurgitation (MR) using a strip that is designed for placement in the posterior annulus only, sparing the anterior annulus and both commissural angles.
METHODS: Valve annular dynamics were analyzed in 51 patients who underwent PMA for MR. In 37 patients (72.5%), additional associated procedures were performed: new chord placement (n = 35), patch valvuloplasty (n = 4), and posterior leaflet augmentation (n = 12). Patients received serial echocardiographic follow-up.
RESULTS: After PMA, the MR grade was nil or mild (0 and 1+) in 47 patients (92.1%), moderate (2+) in 3 patients (5.9%), and moderate to severe (3+) in 1 patient (2.0%). The maximum and minimum septo-lateral dimensions during the cardiac cycle were 21.7 ± 4.8 mm and 18.1 ± 4.1 mm (p < 0.0001), respectively, and the change ratios were 19.8 ± 9.3%. While the septo-lateral dimensions exhibited dynamic changes, the aorto-mitral dimensions remained constant throughout the cardiac cycle.
CONCLUSIONS: PMA preserves dynamic septo-lateral motion of the mitral valve annulus during the cardiac cycle.