Key result
Flexible band repair reduces 2-year moderate or severe MR recurrence by ~10% vs semirigid ring.
Why the study?
Does mitral valve repair using a flexible band improve freedom from moderate or severe mitral regurgitation recurrence compared to a complete semirigid ring in patients with degenerative mitral valve disease?
RCT (n=171)
Simple randomization via computerized random numbers
No
Does mitral valve repair using a flexible band improve freedom from moderate or severe mitral regurgitation recurrence compared to a complete semirigid ring in patients with degenerative mitral valve disease?
Absolute Event Rate: 95.3% vs 85.3%
p-value: p=0.011
In patients with degenerative mitral valve disease, mitral valve repair using a flexible band significantly improved 2-year freedom from moderate or severe mitral regurgitation recurrence compared to a complete semirigid ring.
Flexible bands may be preferred over semirigid rings for degenerative mitral repair; extends randomized evidence on annuloplasty choice for durability.
BACKGROUND: We aimed to compare the outcomes of mitral valve repair with flexible band (FB) versus complete semirigid ring (SR) in degenerative mitral valve disease patients. METHODS: From September 2011 to 2014, 171 patients were randomized and underwent successful mitral valve repair using a SR (n = 85) or FB (n = 86). There were no significant between-group differences at baseline. RESULTS: There were no early mortalities. The mean follow up was 24.7 months. The 2-year survival was 96.0 ± 2.3% (95% confidence interval [CI], 88.6-98.7%) and 94.3 ± 2.8% (95% CI, 85.5-97.9%) in the SR and FB groups, respectively (p = 0.899). The left ventricle remodeling was similar between the groups. Higher transmitral peak (8.5 [3.9-17] vs. 6 [2.1-18] mmHg, p < 0.001), mean pressure gradients (3.7 [1.3-8] vs. 2.8 [0.6-6.8] mmHg, p = 0.001), and systolic pulmonary artery pressure (34.5 [20-68] vs. 29.5 [8-48] mmHg, p < 0.001) was observed in the SR group. The 2-year freedom from recurrence of significant mitral regurgitation was significantly higher in the FB group than the SR group (p = 0.002). Residual mitral regurgitation was an independent prognostic factor of recurrence of mitral regurgitation. The 3-year freedom from reoperation was significantly higher in the FB group than the SR group (p = 0.044). CONCLUSION: Patients with degenerative mitral valve disease may benefit from valve repair with FBs. Residual mitral regurgitation before discharge is an independent risk factor of late insufficiency recurrence. TRIAL REGISTRATION: ClinicalTrials.gov NCT03278574 , retrospectively registered on 06.09.2017.
No takes yet. Share an insight, caveat, or question.
Bogachev‐Prokophiev et al. (2017) conducted an RCT in Degenerative mitral valve disease (n=171). Flexible posterior annuloplasty band vs. Complete semirigid ring was evaluated on Freedom from moderate or severe mitral regurgitation recurrence at 2 years (p=0.011). Mitral valve repair using a flexible band significantly increased 2-year freedom from moderate or severe mitral regurgitation recurrence compared to a complete semirigid ring (95.3% vs 85.3%, p=0.011).