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[Angiocardiographic and clinical development of Carpentier's mitral rings]
Insights
Carpentier
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Mitral Valve Disease Treatment
Context:
- Mitral valve disease affects numerous patients requiring surgical intervention.
- Traditional surgical approaches may have limitations.
- Evaluating novel annuloplasty devices is crucial for improving patient outcomes.
Purpose:
- To assess the efficacy and safety of the Carpentier's ring for mitral annulus reconstruction in patients with mitral valve disease.
- To evaluate the clinical and hemodynamic improvements following mitral valve surgery using Carpentier's ring.
Summary:
- A study involving 79 patients with mitral valve disease demonstrated significant clinical and hemodynamic improvements after mitral annulus reconstruction with Carpentier's ring.
- Postoperative outcomes included reduced mortality (3.8%), decreased mitral regurgitation (from 66.6% to 18.5%), and improved New York Heart Association (NYHA) functional class.
- Mean pulmonary artery pressure decreased, and while atrial enlargement persisted, tromboembolic events were infrequent (2.2%).
Impact:
- Carpentier's ring represents a viable and effective alternative for surgical management of mitral valve disease.
- The findings support the use of this device in improving patient quality of life and reducing valvular dysfunction.
- Further research can explore long-term outcomes and comparisons with other annuloplasty techniques.
Abstract:
Carpentier's ring was inserted in the mitral annulus of 79 patients suffering from mitral valve disease. 49 other patients also underwent surgery on other cardiac valves and are not considered in the present study. The mean follow up time was 19.5 months. The total hospital and late mortality in the isolated ring series was 3.8%. Clinical and hemodynamic improvement was evident postoperatively. The preoperative functional class (NYHA) of the patients was: I, 11.39%; II, 45.5%; III, 34.1%; IV, 8.86% respectively. The postoperative class was: I, 86.8%; II, 7.9%; III, 3.9%; and IV, 1.3% respectively. Postoperative hemodynamic and angiocardiographic evaluation was done in 27 patients. Mean pulmonary artery pressure fell from 49.8 +/- 2.4 mm. Hg to 38 +/- 2 mm. Hg. Mitral regurgitation present preoperatively in 66.6% of cases was present in residual form in only 18.5%. Atrial enlargement was moderate in 42.1% and severe in 57.9% before operation, and 80.3 moderate and 19.7 severe after operation. Tromboembolic accidents occurred in 2 patients (2.2%) both with severe atrial enlargement and atrial fibrillation pre and postoperatively. We conclude that Carpentier's ring is a valid alternative in the surgery of mitral valve disease.