Abstract 16940: Annular Dynamics After Mitral Valve Repair With Different Prosthetic Rings -Real-Time 3-Dimensional Transesophageal Echocardiography Study-
Objective: We assessed the effects of mitral valve repair (MVr) with different types of prosthetic rings on mitral annular dynamics using real-time 3-dimensional echocardiography (RT3DE) in a single center prospective study.
Methods: RT3DE images of the mitral annulus in 39 MVr patients who received a flexible band (Cosgrove, Edwards) (Group F, n=11), semi-flexible ring (Memo3D, Sorin) (SF,n=17), or semi-rigid ring (PhysioII, Edwards) (SR, n=11), and in 8 normal (N) patients were acquired. Annular diameters in the antero-posterior and commissure-commissure, non-planar angle, and 3D annular perimeter, and area were measured throughout the cardiac cycle using 4D MV assessment2®.
Results: The mitral annulus on both the anterior and posterior sides in Groups SF, SR, and N had a saddle-shape configuration, whereas those sides showed a saddle and flat shape, respectively, in Group F. We observed flexible anterior leaflet motion in Groups F, SF, and N, and a flexible posterior leaflet in SF and N. Changes in annular area in Groups F (8.0±3.3%), SF (6.3±2.0%), and N (10.4±4.8%) were significantly greater than in SR (3.5±1.9%). The mitral annulus shape in Groups SF was more ellipsoid as compared to N, while that in F was less ellipsoid. The non-planar angle was significantly lower in Group F.
Conclusion: Both the flexible band and semi-flexible ring retained annular motion, while the semi-flexible and semi-rigid rings showed a saddle shape. The mitral annulus shape with flexible band is different from that with semi-flexible or semi-rigid ring. RT3DE was useful to analyze the detailed motion and flexibility of the mitral annulus.
- © 2013 by American Heart Association, Inc.