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What is the size of an annuloplasty ring made circular?
Gry Dahle, Kjell Arne Rein.
Rikshospitalet, OUS, Oslo, Norway.

OBJECTIVE: Mitral regurgitation is the second most frequent valvular disease. The trend is more valve sparing procedures, preferrably with the use of annuloplasty rings. The repairs may fail and transcatheter valve-in-ring may be an option. Several case reports are available. The semi-rigid rings are oval shaped but will become circular on a rigid valve stent, thought will the circular diameter turn our differernt than the given oval size?
METHODS: Bench tests were done for the CE Physioring 1 (Edwards Lifesciences, Irvine, CA). The different ring sizes were tried on Carbomedics (CM) (CarboMedics Inc, Austin,TX) sizers. Then the outer diameter of the CM sizers were measured by calipiers. In the end Edwards SAPIEN XT (Edwards Lifesciences, Irvine, CA) valves were deployed in the Physiorings. All documented by photo and video.
RESULTS: see table.
A Physioring made circular turns out much smaller than the given size, i.e. a Physioring no 28 fits on a CM sizer 23. The measured outer diameter of a CM sizer is not the same as the given for the sizer.
CONCLUSIONS: Valve-in-ring is feasible for semi-rigid annuloplasty rings. The given size of an annuloplasty ring is not the same when it is made circular. For the moment the Edwards SAPIEN XT may be deployed in Physiorings from size (24)26 to 34.

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