Abstract 15288: Partial Band Mitral Annuloplasty Could Preserve Mitral-Aortic Valve Dynamic Coupling: Comparison Between Pre- and Post-Operative Mitral and Aortic Annular Motion
Introduction: Mitral valve (MV) repair with an annuloplasty ring might unfavorably affect synchronous behavior of mitral-aortic coupling (MAC); however, differences of various types of ring have never been elucidated. Although partial band (PB) mitral annuloplasty could better preserve MAC, there are no data with a comparison between pre-and post-operative MAC.
Objective: To define effects of PB annuloplasty on MAC.
Methods: We retrospectively evaluated 10 patients who underwent MV repair using PB (CG Future band, Medtronic Inc.) for severe degenerative mitral regurgitation. Three-dimensional (3D) transesophageal echocardiography was performed before and after MV repair. 4D-MV Assessment, 2.0 or 2.3 (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 left ventricular outflow tract at the level of hinge points of sinuses, which was reconstructed from 3D datasets. Area change was defined as the maximum minus minimum value normalized to the end-diastolic value.
Results: MA surface and AoA projected areas changed reciprocally throughout cardiac cycle (Fig a and b). Postoperative MA area tended to be smaller compared to the preoperative period (maximum area: 6.6±1.1 vs. 14.0±6.6 cm2, P<0.01: Fig a). Furthermore, postoperative MA surface area change was reduced (8.5±4.8% vs. 14.9±5.9%, P<0.05: Fig c). However, postoperative AoA projected area change was well preserved (Fig b) in the same degree as shown at preoperative period (37.8±11.4% vs. 38.9±11.6%, P=NS: Fig d). Postoperative cyclic change of anteroposterior MA diameter was greater than that of transverse diameter (7.6±3.4% vs.4.3±2.1%, P<0.05) presumably due to preservation of anterior MA motion.
Conclusions: Although PB annuloplasty might reduce physiological MA motion in comparison with preoperative period, it could protect MAC dynamics by preserving AoA motion.
Author Disclosures: N. Wakana: None. T. Yamano: None. H. Watanabe: None. M. Yamano: None. N. Nakanishi: None. T. Ogata: None. K. Zen: None. T. Nakamura: None. H. Yamada: None. K. Doi: None. H. Yaku: None. S. Matoba: None.
- © 2016 by American Heart Association, Inc.