Key result
Geoform ring annuloplasty is linked to a ~74% reduction in mitral regurgitation grade.
Why the study?
Left ventricular remodelling causes functional mitral regurgitation through annular dilatation, leaflet tethering, tenting, and decreased leaflet coaptation, and the mechanisms of valve competency after Geoform ring annuloplasty were not fully understood.
Does mitral valve annuloplasty with the Geoform ring improve mitral valve geometry and reduce regurgitation in patients with ischaemic mitral regurgitation?
Observational (n=7)
Does mitral valve annuloplasty with the Geoform ring improve mitral valve geometry and reduce regurgitation in patients with ischaemic mitral regurgitation?
Absolute Event Rate: 0.9% vs 3.4%
p-value: p=<0.0001
Mitral valve annuloplasty with the Geoform ring effectively modifies mitral annular geometry to restore leaflet coaptation and reduce ischaemic mitral regurgitation.
3D echo links Geoform ring to reduced annular dimensions and MR; extends mechanistic data in ischaemic MR but leaves open durability.
AIMS: Left ventricular remodelling leads to functional mitral regurgitation resulting from annular dilatation, leaflet tethering, tenting, and decreased leaflet coaptation. Mitral valve annuloplasty restores valve competency, improving the patient's functional status and ventricular function. This study was designed to evaluate the mechanisms underlying mitral valve competency after the implantation of a Geoform annuloplasty ring using three-dimensional (3D) echocardiography. METHODS AND RESULTS: Seven patients (mean age of 65 years) with ischaemic mitral regurgitation underwent mitral valve annuloplasty with the Geoform ring and coronary artery bypass surgery. Pre- and post-operative 3D echocardiograms were performed. Following mitral annuloplasty, mitral regurgitation decreased from 3.4+/-0.2 to 0.9+/-0.3 (P-value<0.0001), mitral valve tenting volume from 13+/-1.7 to 3.2+/-0.3 mL (P-value<0.001), annulus area from 12.6+/-1.0 to 3.3+/-0.2 cm2 (P-value<0.0001), valve circumference from 13+/-0.5 to 7.3+/-0.3 cm (P-value<0.0001), septolateral distance from 2.1+/-0.1 to 1.4+/-0.06 cm (P-value<0.01) and intercommissural distance from 3.4+/-0.1 to 2.7+/-0.03 cm (P-value<0.03). There was significant decrease in the septolateral distance at the level of A2-P2 with respect to other regions. These geometric changes were associated with the improvement in the NYHA class from 3.1+/-0.3 to 1.3+/-0.3 (P-value<0.002). CONCLUSION: The mitral valve annuloplasty with the Geoform ring restores leaflet coaptation and eliminates mitral regurgitation by effectively modifying the mitral annular geometry.
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Armen et al. (2008) conducted an observational in ischaemic mitral regurgitation (n=7). Mitral valve annuloplasty with the Geoform ring vs. Pre-operative baseline was evaluated on Mitral regurgitation (p=<0.0001). Mitral valve annuloplasty with the Geoform ring significantly reduced mitral regurgitation from 3.4 to 0.9 (P<0.0001) and improved NYHA class from 3.1 to 1.3 (P<0.002).
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