Impact of type and size of annuloplasty prosthesis on hemodynamic status after mitral valve repair for degenerative disease. (June 2020)

• Record Type: Journal Article
• Authors: Hiraoka, Arudo; Hayashida, Akihiro; Toki, Misako; Chikazawa, Genta; Yoshitaka, Hidenori; Yoshida, Kiyoshi; Sakaguchi, Taichi
• Is Part Of: IJC heart & vasculature. Volume 28(2020)
• Publication Date: 2020-06
• Subjects: Mitral valve repair -- Degenerative disease -- Hemodynamics -- Functional mitral stenosis; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2020.100517
• Languages: English
• ISSNs: 2352-9067

Abstract

Abstract: Objective: The aim of this study is to evaluate mitral valve hemodynamics after mitral valve repair for degenerative disease, and seek the impact of type/size of annuloplasty prosthesis on resting cardiac hemodynamics. Methods: Between October 2012 and June 2019, 301 patients underwent isolated mitral valve repair for degenerative disease were enrolled. Correlation between postoperative mitral hemodynamics and type/size of annuloplasty prosthesis was evaluated. Results: There were significant correlations between annuloplasty size and peak velocity (r = −0.41, p < 0.001), peak transmitral pressure gradient (TMPG) (r = −0.40, p < 0.001), mean TMPG (r = −0.41, p < 0.001), effective orifice area (EOA) (r = 0.26, p < 0.001), and pulmonary artery systolic pressure (r = −0.15, p = 0.010). In patients with larger annuloplasty prostheses (≥30 mm), the type of annuloplasty prosthesis (band or ring) did not influence the mitral hemodynamics, however, mean TMPG was significantly greater in patients with a full ring (2.9 mmHg [2.1–3.7] vs. 4.0 mmHg [2.8–5.0], p < 0.001) in patients with smaller annuloplasty (<30 mm). Left ventricular ejection fraction and stroke volume were significantly associated with an increase of TMPG (r = 0.14, p = 0.016 and r = 0.24, p < 0.001). Conclusions: A larger partial band had the potential to improve mitral hemodynamics after mitral repair for degenerative disease. However, echocardiographic mitral hemodynamics was influenced by LV function. Therefore, a more accurate method is required to elucidate the true impact of mitral repair on hemodynamics.