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Updated: Apr 3, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Single-Center Experience With Adjustable Annuloplasty Ring in Degenerative Mitral Regurgitation
Markus Czesla1, Julia Götte, Vladimir Voth
1From the Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Germany.
Objective:
Owing to the complex anatomy of the mitral valve, successful surgical repair of degenerative regurgitation remains a challenging procedure in cardiac surgery.
Methods:
This paper aimed to report on our single-center experience with 20 patients who received an adjustable annuloplasty ring (Cardinal ring, ValtechCardio Ltd, Or Yehuda, Israel) as part of their mitral valve repair procedure. The device allows for intraoperative echocardiography-guided ring size adjustments under beating-heart conditions.
Results:
All of the 20 patients left the operating room without any residual mitral regurgitation. There was no risk of systolic anterior movement (SAM) because of image-guided fine tuning of the ring before weaning the patient from bypass.
Conclusions:
Further multicenter data are required to prove the concept of adjustable annuloplasty devices.
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