Mitral valve repair using a semirigid ring: patient selection and early outcomes. (September 2016)

• Record Type: Journal Article
• Authors: Wan, Song; Lee, Alex PW; Attaran, Saina; Yu, Peter SY; Au, Sylvia SW; Kwok, Micky WT; Lau, Rainbow WH; Wong, Randolph HL; Wan, Innes YP; Ng, Siu-Keung; Underwood, Malcolm J
• Is Part Of: Asian cardiovascular & thoracic annals. Volume 24:Number 7(2016)
• Page Start: 647
• Page End: 652
• Publication Date: 2016-09
• Subjects: Echocardiography -- three-dimensional -- Mitral valve -- Mitral valve annuloplasty -- Mitral valve insufficiency -- Prosthesis design; Heart -- Diseases -- Asia -- Periodicals; Heart -- Diseases -- Pacific Area -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Surgery -- Asia -- Periodicals; Heart -- Surgery -- Pacific Area -- Periodicals; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Asia -- Periodicals; Chest -- Surgery -- Pacific Area -- Periodicals; Chest -- Surgery -- Periodicals; 617.412
• DOI: 10.1177/0218492316659970
• Languages: English
• ISSNs: 0218-4923

Abstract

Background: Commonly used complete mitral annuloplastic rings include saddle-shaped and semirigid rings, with no clear indication for either type. A semirigid ring may be preferred in patients whose native mitral saddle shape is well maintained. We present our experience of using semirigid rings for mitral valve repair. Methods: We routinely measured the annular height-to-commissural width ratio by 3-dimensional transesophageal echocardiography prior to mitral repair. We generally chose a semirigid (Memo 3D) ring in patients whose annular height-to-commissural width ratio was normal (≥ 15%). The same semirigid ring with an additional chordal guiding system (Memo 3D ReChord) was selected for patients with anterior leaflet or bileaflet pathology. Over an 18-month period, 66 patients with severe degenerative ( n = 60) or functional ( n = 6) mitral regurgitation had Memo 3D ( n = 32) or Memo 3D ReChord ( n = 34) rings implanted. Results: Postoperative 3-dimensional transesophageal echocardiography was completed in all patients (mean follow-up 7 ± 5 months). The majority of patients had no or mild residual mitral regurgitation; only two had moderate (2+) mitral regurgitation. There was no mortality at 30-days or on midterm follow-up. Conclusions: Our series represents the first Asian clinical experience using the Memo 3D ReChord ring. Although the long-term durability of mitral repair with this type of semirigid annuloplastic ring warrants further validation, our current clinical data are encouraging.