Response by Capoulade et al to Letter Regarding Article, “Impact of Left Ventricular to Mitral Valve Ring Mismatch on Recurrent Ischemic Mitral Regurgitation After Ring Annuloplasty”
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We thank Dr Pocar for his insightful comments regarding our study.1 Several studies focusing on mitral valve (MV) annuloplasty in patients with ischemic mitral regurgitation (IMR) have highlighted a significant recurrence rate of IMR after the procedure (>30% at 1 year).2–4 One of the main mechanisms for this recurrence is the persistence of MV leaflet tethering after restrictive annuloplasty.5
MV annuloplasty using a downsized ring size according to intertrigonal distance or anterior MV leaflet size may exacerbate posterior leaflet tethering, especially if the lateral wall of the left ventricle (LV) remains displaced …