Key result
Mitral valve repair without ring annuloplasty significantly reduced mitral annulus size (mean maximum area 14.34 vs 10.45 cm2; p<0.001) while preserving annulus mobility at 2-year follow-up.
Why the study?
The study aimed to evaluate mitral annulus dynamics using cardiac magnetic resonance in patients with degenerative mitral insufficiency undergoing mitral valve repair.
Does mitral valve repair without ring annuloplasty reduce mitral annulus size and preserve mobility in patients with degenerative mitral insufficiency?
Cohort (n=29)
Does mitral valve repair without ring annuloplasty reduce mitral annulus size and preserve mobility in patients with degenerative mitral insufficiency?
p-value: p=<0.001
Mitral valve repair using quadrangular resection without ring annuloplasty significantly reduces mitral annulus size while preserving its mobility at 2 years.
Ringless repair may preserve annular dynamics in degenerative mitral insufficiency; hypothesis-generating and should not yet change annuloplasty practice.
OBJECTIVES: The aim of this study was to analyze mitral annulus (MA) dynamics using cardiac magnetic resonance (CMR) in patients with degenerative mitral insufficiency who underwent mitral valve repair (MVR). METHODS: Mitral valve imaging was performed by CMR in twenty-nine patients with degenerative mitral insufficiency who underwent MVR between July 2014 and August 2016, with quadrangular resection of the posterior leaflet without ring annuloplasty. They were prospectively followed up from the preoperative period up to 2 years postoperatively. RESULTS: We observed a significant reduction in all measurements of the MA after surgery. The mean systolic circumference of the MA was reduced from 13.28±1.95 cm to 11.50±1.59 cm, and the diastolic circumference was reduced from 12.51±2.01 cm to 10.66±2.09 cm in the immediate postoperative period, measures that remained stable 2 years after MVR (p<0.001). The mean maximum area of the MA was significantly reduced from 14.34±4.03 to 10.45±3.17 cm2 when comparing the immediate postoperative period and the 2 year follow-up (p<0.001). The same occurred with the mean minimum area of the MA, which was reduced from 12.53±3.68 cm2 to 9.23±2.84 cm2 in the same period, and this reduction was greater in the antero-posterior diameter than in the mid-lateral diameter. The mobility of the MA was preserved after surgery, ranging between 19.6% and 25.7% at 2-year follow-up. CONCLUSION: We observed a significant reduction in the MA size after MVR, with preservation of the MA mobility at the 2-year follow-up.
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Abdouni et al. (2020) conducted a cohort in Degenerative mitral insufficiency (n=29). Mitral valve repair without ring annuloplasty vs. Preoperative baseline was evaluated on Mitral annulus size and dynamics (p=<0.001). Mitral valve repair without ring annuloplasty significantly reduced mitral annulus size (mean maximum area 14.34 vs 10.45 cm2; p<0.001) while preserving annulus mobility at 2-year follow-up.
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