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First experiences with adjustable annuloplasty in degenerative MR patients
Markus Czesla.
Sana Herzchirurgie Stuttgart, Stuttgart, Germany.

OBJECTIVE: The use of an adjustable, semi-rigid annuloplasty ring in patients with degenerative MR allows post pump adjustment for optimal results in valve repair.
METHODS: Participating in a post market study to evaluate to clinical outcome using this novel device currently 20 patients have been enrolled at our institution. All patients were scheduled for mitral valve repair and experienced post-pump ring adjustment for optimization of coaptation under real time echocardiography guidance.
RESULTS: All patients presented with anterior, posterior, bileaflet prolaps or even barlow disease were treated with implantation of neochordae following annuloplasty. Postoperative off pump adjustment by a mechanical rotating cable attached to the ring leads to an increase in coaptation length up to 4 mm and a disappearance of residual MR.
CONCLUSIONS: Postoperative results in all patients were satisfying without any residual MR. The repair of anterior or bileaflet prolapse proves sometimes to be difficult in terms of the correct length of the neocardae. Using postoperative adjustment of the ring diameter may compensate any inaccuracy and prevent SAM phenomenon.
In our experiences the adjustable annuloplasty device may have the potential for regular use in patients with degenerative mitral valve disease.


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