Is a Profiled Annuloplasty Ring Suitable for Repair of Degenerative Mitral Regurgitation? A Single-Center Experience Comprising 200 Patients

被引:6
作者
Guenzinger, Ralf [1 ]
Guenther, Thomas [1 ]
Ratschiller, Thomas [1 ]
Minkner, Kathrin [1 ]
Rondak, Ina-Christine [2 ]
Voss, Bernhard [1 ]
Lange, Ruediger [1 ,3 ]
机构
[1] Tech Univ Munich, German Heart Ctr Munich, Dept Cardiovasc Surg, Munich, Germany
[2] Tech Univ Munich, Inst Med Stat & Epidemiol, Munich, Germany
[3] DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany
关键词
mitral valve repair; valve surgery; cardiopulmonary bypass; VALVE REPAIR; LEAFLET PROLAPSE; POSTERIOR LEAFLET; ANNULAR GEOMETRY; SADDLE-SHAPE; DISEASE; ECHOCARDIOGRAPHY; RECONSTRUCTION; REPLACEMENT; MORPHOLOGY;
D O I
10.1055/s-0035-1563539
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundVarious devices have been proposed for ring annuloplasty in patients with degenerative mitral valve disease. This study reports for the first time midterm results with the rigid three-dimensional Medtronic Profile 3D (Medtronic, Minneapolis, Minnesota, United States) annuloplasty ring. MethodsBetween June 2009 and June 2011, 200 patients (mean age 6113 years, 70% male) with severe degenerative mitral regurgitation underwent mitral valve repair using the Medtronic Profile 3D annuloplasty ring. A total of 106 patients (53.0%) underwent isolated mitral valve repair and 94 patients (47.0%) underwent a concomitant procedure such as coronary artery bypass grafting (n=21), tricuspid valve surgery (n=49), AF ablation (n=17), and aortic valve surgery (n=13). The follow-up is 94.5% complete (mean 2.50.5 years). ResultsThirty-day mortality was 1.5%. Survival at 3 years was 97.1 +/- 1.6% for isolated procedures and 92.4 +/- 2.8% for combined procedures (p=0.137). Freedom from mitral valve-related reoperation at 3 years was 97.1 +/- 1.7% for isolated procedures and 95.5 +/- 2.2% for combined procedures (p=0.561). Seven patients (3.5%) required a mitral valve-related reoperation. Two of these reoperations were required for endocarditis, two for ring dehiscence, one for progression of the native disease (flail leaflet), one for leaflet suture dehiscence, and one for persistent systolic anterior motion. ConclusionThe three-dimensional Medtronic Profile 3D annuloplasty ring is suitable for mitral valve repair for degenerative diseases. This saddle-shaped annuloplasty device provides excellent early results with a very good functional outcome at midterm either in isolated or combined procedures.
引用
收藏
页码:434 / 440
页数:7
相关论文
共 26 条
[1]   THE PHYSIO-RING - AN ADVANCED CONCEPT IN MITRAL-VALVE ANNULOPLASTY [J].
CARPENTIER, AF ;
LESSANA, A ;
RELLAND, JYM ;
BELLI, E ;
MIHAILEANU, S ;
BERREBI, AJ ;
PALSKY, E ;
LOULMET, DF .
ANNALS OF THORACIC SURGERY, 1995, 60 (05) :1177-1186
[2]   INITIAL EXPERIENCE WITH THE COSGROVE-EDWARDS ANNULOPLASTY SYSTEM [J].
COSGROVE, DM ;
ARCIDI, JM ;
RODRIGUEZ, L ;
STEWART, WJ ;
POWELL, K ;
THOMAS, JD .
ANNALS OF THORACIC SURGERY, 1995, 60 (03) :499-504
[3]   Late Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease [J].
David, Tirone E. ;
Armstrong, Susan ;
McCrindle, Brian W. ;
Manlhiot, Cedric .
CIRCULATION, 2013, 127 (14) :1485-1492
[4]   Recurrence of mitral valve regurgitation after mitral valve repair in degenerative valve disease [J].
Flameng, W ;
Herijgers, P ;
Bogaerts, K .
CIRCULATION, 2003, 107 (12) :1609-1613
[5]   Should Patients With Severe Degenerative Mitral Regurgitation Delay Surgery Until Symptoms Develop? [J].
Gillinov, A. Marc ;
Mihaljevic, Tomislav ;
Blackstone, Eugene H. ;
George, Kristopher ;
Svensson, Lars G. ;
Nowicki, Edward R. ;
Sabik, Joseph F., III ;
Houghtaling, Penny L. ;
Griffin, Brian .
ANNALS OF THORACIC SURGERY, 2010, 90 (02) :481-488
[6]   Regional Annular Geometry in Patients With Mitral Regurgitation: Implications for Annuloplasty Ring Selection [J].
Jassar, Arminder S. ;
Vergnat, Mathieu ;
Jackson, Benjamin M. ;
McGarvey, Jeremy R. ;
Cheung, Albert T. ;
Ferrari, Giovanni ;
Woo, Y. Joseph ;
Acker, Michael A. ;
Gorman, Robert C. ;
Gorman, Joseph H., III .
ANNALS OF THORACIC SURGERY, 2014, 97 (01) :64-70
[7]   Saddle-shaped mitral valve annuloplasty rings improve leaflet coaptation geometry [J].
Jensen, Morten O. ;
Jensen, Henrik ;
Levine, Robert A. ;
Yoganathan, Ajit P. ;
Andersen, Niels Trolle ;
Nygaard, Hans ;
Hasenkam, J. Michael ;
Nielsen, Sten L. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2011, 142 (03) :697-703
[8]   Effects of a saddle shaped annulus on mitral valve function and chordal force distribution:: An in vitro study [J].
Jimenez, JH ;
Soerensen, DD ;
He, ZM ;
He, SQ ;
Yoganathan, AP .
ANNALS OF BIOMEDICAL ENGINEERING, 2003, 31 (10) :1171-1181
[9]   Quantitative Analysis of Mitral Valve Morphology in Mitral Valve Prolapse With Real-Time 3-Dimensional Echocardiography Importance of Annular Saddle Shape in the Pathogenesis of Mitral Regurgitation [J].
Lee, Alex Pui-Wai ;
Hsiung, Ming C. ;
Salgo, Ivan S. ;
Fang, Fang ;
Xie, Jun-Min ;
Zhang, Yan-Chao ;
Lin, Qing-Shan ;
Looi, Jen-Li ;
Wan, Song ;
Wong, Randolph H. L. ;
Underwood, Malcolm J. ;
Sun, Jing-Ping ;
Yin, Wei-Hsian ;
Wei, Jeng ;
Tsai, Shen-Kou ;
Yu, Cheuk-Man .
CIRCULATION, 2013, 127 (07) :832-841
[10]   THE RELATIONSHIP OF MITRAL ANNULAR SHAPE TO THE DIAGNOSIS OF MITRAL-VALVE PROLAPSE [J].
LEVINE, RA ;
TRIULZI, MO ;
HARRIGAN, P ;
WEYMAN, AE .
CIRCULATION, 1987, 75 (04) :756-767