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The "physio-ring": an advanced concept in mitral valve annuloplasty
A F Carpentier1, A Lessana, J Y Relland
1Department of Cardiovascular Surgery and Organ Transplantation, Hôpital Broussais, Paris, France.
The Annals of Thoracic Surgery
|November 1, 1995
Summary
A new flexible annuloplasty ring shows promising results for mitral valve repair, with excellent outcomes in most patients. Proper ring selection and sizing are crucial for successful mitral valve reconstruction.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Cardiac Valve Repair
Background:
- A novel flexible annuloplasty ring was developed to enhance the remodeling annuloplasty concept.
- This study evaluates its clinical application, focusing on segmental valve analysis and precise valve sizing.
Purpose of the Study:
- To assess the efficacy and safety of a new flexible annuloplasty ring in mitral valve repair.
- To emphasize the importance of segmental valve analysis and accurate valve sizing in surgical outcomes.
Main Methods:
- 137 patients (aged 4-76 years) with mitral valve insufficiency underwent surgical repair using Carpentier techniques.
- Indications were based on insufficiency severity (90 patients grade III/IV), with 119 cases of leaflet prolapse (type II).
- Intraoperative echocardiography guided ring selection, with 3 instances of inadequate sizing leading to anterior leaflet systolic anterior motion.
Main Results:
- Mid-term follow-up (6-18 months) in 94 patients showed trivial/no regurgitation in 93.2% and minimal in 6.8%.
- Postoperative echocardiography revealed decreased left ventricular end-systolic diameter and volume, indicating improved cardiac function.
- Average transmitral diastolic gradient was 3.55 +/- 1.93 mm Hg.
Conclusions:
- The preliminary experience with the flexible annuloplasty ring yielded promising results for mitral valve repair.
- The study highlights the critical role of accurate valve sizing and appropriate ring selection for optimal surgical outcomes.
- Indications for the new ring versus the classic ring were defined based on this experience.