What is the clinical evidence from this study?

Study design: Cohort. Population: Mitral valve annuloplasty ring dehiscence (n=3478). Intervention: Mitral valve repair with ring annuloplasty. Primary outcome: Incidence of annuloplasty ring dehiscence requiring reoperation.

What does this research mean for the field?

Isolated mitral valve repair with ring annuloplasty is associated with a 1.6% incidence of ring dehiscence requiring reoperation, which most frequently localizes on the posterior annulus and can be safely treated with a 30-day mortality rate of 2%. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 10, 2019Open Access

Annuloplasty ring dehiscence after mitral valve repair: incidence, localization and reoperation

Key Result

Isolated mitral valve repair with ring annuloplasty was associated with a 1.6% incidence of ring dehiscence requiring reoperation, with a 30-day mortality rate of 2% after reintervention.

Study Design

Type

Cohort (n=3,478)

Multicenter

Structured PICO

What are the incidence, localization, and clinical outcomes of annuloplasty ring dehiscence after mitral valve repair?

Population

3,478 patients who underwent isolated mitral valve repair with ring annuloplasty, of whom 57 (1.6%) required reoperation for annuloplasty ring dehiscence

Intervention

Reoperation (mitral valve replacement or re-repair) for annuloplasty ring dehiscence

Outcome

Incidence, localization, and short- and long-term survival rates after reoperation for annuloplasty ring dehiscencehard clinical

Annuloplasty ring dehiscence is a rare complication (1.6%) after mitral valve repair, most commonly affecting the posterior annulus, and reoperation can be performed with low 30-day mortality (2%).

Abstract

OBJECTIVES: Mitral valve (MV) annuloplasty ring dehiscence with subsequent recurrent mitral regurgitation represents an unusual but challenging clinical problem. Incidence, localization and outcomes for this complication have not been well defined. METHODS: From 1996 to 2016, a total of 3478 patients underwent isolated MV repair with ring annuloplasty at the Leipzig Heart Centre. Of these patients, 57 (1.6%) underwent reoperation due to annuloplasty ring dehiscence. Echocardiographic data, operative and early postoperative characteristics as well as short- and long-term survival rates after MV reoperation were analysed. RESULTS: Occurrences of ring dehiscence were acute (1 year) in 44%, 33% and 23% of patients, respectively. Localization of annuloplasty ring dehiscence was found most frequently in the P3 segment (68%), followed by the P2 (51%) and the P1 segments (47%). The 30-day mortality rate and 1- and 5-year survival rates after MV reoperation were 2%, 89% and 74%, respectively. During reoperation, MV replacement was performed in 38 (67%) and MV re-repair in 19 (33%) patients. CONCLUSIONS: Annuloplasty ring dehiscence is clinically less common, localized more frequently on the posterior annulus and occurs mostly acutely or early after MV repair. MV reoperation can be performed safely in such patients.

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Cite This Study

Noack et al. (Wed,) conducted a cohort in Mitral valve annuloplasty ring dehiscence (n=3,478). Mitral valve repair with ring annuloplasty was evaluated on Incidence of annuloplasty ring dehiscence requiring reoperation. Isolated mitral valve repair with ring annuloplasty was associated with a 1.6% incidence of ring dehiscence requiring reoperation, with a 30-day mortality rate of 2% after reintervention.

synapsesocial.com/papers/6a1a2cd0db849bfdc47fc9cc https://doi.org/https://doi.org/10.1093/ejcts/ezz219

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