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Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection
Johannes H Jedrzejczyk1,2, Lisa Carlson Hanse1,2, Shadi Javadian1,2
1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
Frontiers in Cardiovascular Medicine
|January 21, 2022
Summary
Choosing the right mitral annuloplasty ring is key for treating mitral regurgitation. Rigid rings offer more remodeling for dilated annuli (Types I, IIIa/b), while flexible rings suit non-dilated annuli (Type II).
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Mitral regurgitation (MR) necessitates effective annuloplasty device selection.
- Carpentier's classification guides MR type and treatment strategy.
Approach:
- Literature search using "mitral valve annuloplasty" on PubMed, Google Scholar, and Web of Science.
- Systematic assessment of identified publications.
Key Points:
- Mitral annuloplasty rings vary in rigidity (rigid, semi-rigid, flexible) impacting remodeling capabilities.
- Saddle-shaped rings are preferred over flat ones for reduced stress and better coaptation.
- Ring type (complete/partial) and shape influence surgical outcomes.
Conclusions:
- Downsized rigid/semi-rigid rings are beneficial for MR Types I, IIIa, and IIIb due to annular dilation.
- Normosized flexible rings may suffice for Type II MR, promoting physiological repair without annular dilation.
- Individual patient morphology must guide mitral annuloplasty ring selection for optimal repair.
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