Functional and Degenerative Mitral Regurgitation: One Ring Fits All?

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Heart Valve Repair

Background:

• Three-dimensional saddle-shaped annuloplasty rings enhance leaflet coaptation during mitral valve repair (MVR).
• This may improve the durability of MVR for functional mitral regurgitation (FMR) and degenerative mitral regurgitation (DMR).

Purpose of the Study:

• To report the mid-term results of MVR using a rigid three-dimensional annuloplasty ring (Profile 3D, Medtronic).
• To evaluate the efficacy and durability of this device in patients with DMR and FMR.

Main Methods:

• A cohort of 369 patients (326 with DMR, 43 with FMR) underwent MVR between June 2009 and June 2012.
• Follow-up was conducted in 94.9% of patients, with a mean follow-up of 4.9 years.
• Echocardiographic assessments were completed in 93.2% of patients, with a mean follow-up of 4.3 years.

Main Results:

• 30-day mortality was 1.5% for DMR and 9.3% for FMR.
• Six-year survival was 92.1% for DMR and 66.4% for FMR.
• Cumulative mitral valve reoperation risk at 6 years was 7.1% for DMR and 0% for FMR; only one patient had MR greater than moderate.

Conclusions:

• MVR using the 3D Profile 3D annuloplasty ring demonstrates excellent mid-term results for FMR, with minimal MR recurrence.
• Results for DMR are comparable to current literature, indicating the device's effectiveness in both conditions.