Changes in the mitral valve annular angles after mitral valve repair for functional mitral regurgitation.

OBJECTIVES: Narrow aorto-mitral and mitral-septal angles have been reported to be associated with cardiovascular events following mitral valve repair. This study aimed to evaluate pre- and postoperative changes in these angles across different MR etiologies. METHODS: From January 2012 to June 2023, 394 patients underwent mitral valve repair. Of these, 17 patients had atrial functional (AFMR), 42 had ventricular functional (VFMR), and 335 had degenerative mitral regurgitation (DMR); for DMR, 48 cases between July 2021 and June 2023 were included in the study. Changes in parameters of echocardiography, aorto-mitral and mitral-septal angles were evaluated. RESULTS: All patients received ring annuloplasty; 9 AFMR patients also underwent Left atrial plication. Aorto-mitral and mitral-septal angles were largest in patients with VFMR preoperatively (p < 0.001) and decreased postoperatively in VFMR and DMR (p < 0.001). In AFMR, changes in these angles were different between those undergoing left atrial plication (increase in these angles) and those not undergoing plication (decrease in these angles) (interaction in repeated measures ANOVA, aorto-mitral p = 0.015, mitral septal p = 0.085). CONCLUSION: Preoperative aorto-mitral and mitral-septal angles were greater in patients with VFMR. Mitral valve repair with ring annuloplasty resulted in decrease in these angles, which was prevented by left atrial plication in AFMR.