Latest Advances in Annuloplasty Protheses for Valvular Reconstructive Surgery.

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Medical Devices

Background:

• Surgical heart valve repair is increasingly common, with annuloplasty as the gold standard for mitral valve regurgitation.
• Techniques for mitral valve reconstruction are established, yet the optimal annuloplasty ring type (rigid, flexible, etc.) is debated.
• Functional tricuspid regurgitation treatment has evolved from suture-based to device-based annuloplasty, showing superior outcomes.

Purpose of the Study:

• To review current annuloplasty prostheses used in valvular reconstructive surgery.
• To discuss the available types of annuloplasty rings and their application in mitral, tricuspid, and aortic valve repair.
• To provide a reference for surgeons and students regarding annuloplasty ring selection.

Main Methods:

• Review of existing literature and clinical data on annuloplasty prostheses.
• Comparison of outcomes between different annuloplasty techniques and ring types.
• Description of various annuloplasty ring designs and modifications.

Main Results:

• Annuloplasty is the gold standard for mitral valve regurgitation repair.
• Device-based annuloplasty demonstrates superior long-term outcomes compared to suture-based methods for tricuspid regurgitation.
• Aortic valve repair is complex, with annuloplasty crucial for managing aortic regurgitation, though no single method is standardized.

Conclusions:

• The choice of annuloplasty ring for mitral valve repair remains largely surgeon-dependent rather than evidence-based.
• While device-based annuloplasty is superior for tricuspid regurgitation, the flexible versus rigid ring debate continues.
• Standardization of annuloplasty techniques for aortic regurgitation is lacking, highlighting the need for further research.