Abstract 15498: Partial Band Mitral Annuloplasty Can Preserve Mitral-aortic Valve Dynamic Coupling After Mitral Valve Repair in Comparison With Complete Ring Plasty
Introduction: The aortic and mitral valves (MV) demonstrate synchronous behavior to facilitate both left ventricular (LV) filling and emptying. Although partial band (PB) mitral annuloplasty is often performed to maintain anterior annulus flexibility, actual advantages remain undefined. The object of this study is to identify the effects of PB annuloplasty compared with complete ring (CR).
Methods: We retrospectively evaluated 24 patients who underwent MV repair for degenerative mitral regurgitation. A PB (CG Future band, Medtronic Inc) was used in 13 patients and a CR (Carpentier-Edwards Physio or Physio II ring, Edwards Lifesciences) in 11. Three-dimensional transesophageal echocardiography was performed and 4D-MV Assessment, 2.0 (TomTec Imaging Systems) was used for semiautomatic tracking of mitral annulus (MA). Aortic annulus (AoA) was manually traced frame by frame in transverse plane perpendicular to LV outflow tract at the level of hinge points of sinuses, which was reconstructed from three-dimensional datasets.
Results: MA surface and AoA projected areas changed reciprocally throughout cardiac cycle (Fig a and b). The PB orifice area measured in vitro was smaller than CR (4.8±0.9 vs 5.8±1.2 cm2, P<0.05). There was no difference in patients’ body surface area (1.57±0.21 vs 1.67±0.20 m2). However, the MA area in PB constantly tended to be larger than in CR (maximum area: 8.1±2.0 vs 6.7±1.5 cm2, P=0.09, Fig a). In PB, MA surface area change was greater (10.1±6.0% vs 5.9±2.9%, P<0.05: Fig c); consequently, AoA projected area change was much larger than in CR (39.2±11.0% vs 18.4±4.2%, P<0.01: Fig d). Immediately postoperative residual regurgitation was none or of mild degree in all patients, and Doppler transmitral mean pressure gradient tended to be smaller in PB than in CR (2.0±0.4 vs 2.3±0.9 mmHg, P=0.32).
Conclusions: PB mitral annuloplasty could preserve mitral-aortic dynamic coupling, which must provide important consideration at the time of MV repair.
Author Disclosures: N. Wakana: None. T. Yamano: None. H. Watanabe: None. M. Yamano: None. N. Nakanishi: None. T. Ogata: None. T. Nakamura: None. H. Shiraishi: None. T. Ueyama: None. S. Matoba: None. H. Yamada: None. K. Doi: None. A. Matsumuro: None. T. Shirayama: None. H. Yaku: None.
- © 2015 by American Heart Association, Inc.