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OBJECTIVE: Contemporary mitral valve repair aims at correction of leaflet function and stabilization of the annulus using closed or open annuloplasty rings. Aim of this study was to compare outcome after mitral valve repair using open annuloplasty (OA) rings (Cosgrove) versus closed annuloplasty (CA) rings (Physio).
METHODS: 507 patients who received minimally invasive mitral valve surgery between February 2009 and April 2014 were evaluated. Mitral valve pathology was degenerative in 438 patients. 214 patients had OA and 293 patients CA, respectively.
RESULTS: Mean age was 65.0+-12.5 years (OA) vs 62.0+-11.6 years (CA) (p=0.005). Left ventricular ejection fraction (LVEF) was 57.7%+-11.2 (OA) vs 58.6%+-10.2 (CA) (p=0.386). Cross-clamp time was 89.1+-32.8 min in (OA) versus 89.6+-34.7 min in (CA) (p=0.872). Neocord implantation was used at the anterior leaflet in 15% (OA) versus 37% (CA) and at the posterior leaflet in15.4% (OA) versus 40.3% (CA), respectively. Repair rate was comparatively high 96.78% in (OA) vs 96.28% in (CA). Overall mortality was acceptable with 2.37 %. Postoperative none/trace MR was 96.7% (OA) vs 97.6% (CA) and mild MR 2.34% (OA) vs 2.39% (CA). Moderate or severe MR occurred in 2 patients of OA group (0.47%). Systolic anterior motion as a reason for severe mitral regurgitation was present in 4% of patients
CONCLUSIONS: Minimally invasive mitral valve repair can be accomplished with good outcomes and a high repair rate using standard techniques including OA and CA, without affecting the cross clamp time. In case of future need for repeat intervention CA may provide a better landing zone for potential interventional valve implantation.