Dynamic mitral annular motion after posterior mitral annuloplasty: Use of a strip that is designed for placement in the posterior annulus.

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.