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Early Results Of Mitral Valve Repair With A New Semirigid Ring With Removable Loops For Chordal Length Adjustment
Alfredo Giuseppe Cerillo, Francesca Petrini, Giulio Pellegrini, Anna Laganą, Anna Rita Manca, Paolo De Cillis, Lucio Braconi, Pierluigi Stefano;
Careggi University Hospital, Florence, Italy
BACKGROUND: The recent saddle-shape semirigid ring with removable loops for chordal length adjustment, with a wider range of sizes (24-42 mm), progressive increase of the AP diameter, gradual anterior saddle shaping, preserved annular dynamics, rechord system.The aim of this study is to report our early results of mitral valve repair using this new annuloplasty ring.
METHODS: 43 consecutive patient undergoing mitral valve repair were enrolled. We considered in-hospital mortality, major complications, residual mitral regurgitation, procedural failure and postoperative mitral stenosis to define early results.Preoperative, intraoperative and postoperative characteristics were expressed as means and percentages.
RESULTS: 19 patients (44%) underwent combined procedures (4 aortic valve replacement and 7 CABG). Mean age was 65.3 ± 13.4 and mean STS score was 3.7 ± 6.7. 10 patients (23.3%) had associated atrial fibrillation, 4 patients (9.3%) had pulmonary hypertension was observed in 19 patients (44.2%). Minimally invasive approach through right anterolateral minithoracotomy was performed for isolated mitral regurgitation with or without tricuspid annuloplasty and atrial fibrillation ablation/left atrial appendage closure.Mean CPB time was 110 min +/- 27 min and mean cross-clamp time was 83.2 min +/- 1.4 min. 23 patients (53.5%) underwent leaflet procedures: 14 posterior mitral leaflet resection and 13 neochordae implantations.In-hospital mortality was 2% (one patient was on ECMO at the admission with massive MR due to ischemic papillary muscle rupture). 3 patients (7%) developed major complications: 1 stroke and 2 pacemaker implantations for complete atrio-ventricular block. Early failure rate was 0% and patients has no significant postoperative mitral stenosis. Reduction in mitral regurgitation (<2+/4+) at discharge was observed in 41 patients (97.6%).
CONCLUSIONS: Our study demonstrated good preliminary results of mitral annuloplasty with the new annuloplasty ring, suggesting its safety and effectiveness. It seems to be suitable for treatment of a wide range of conditions and for different repair techniques, especially through a minimally invasive approach.Further studies are needed to investigate long term results.
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