Initial experience with the Cosgrove-Edwards annuloplasty system

Mitral valve repair with a malleable bovine pericardium ring

“…It differs from the flexible synthetic ring developed by Duran and Ubago 13 of the second ring generation 21 by not involving the whole mitral valve circumference. During evolution, it was shown to be satisfactory in patients who underwent annuloplasty, in agreement with previously presented results 26,28,29 .…”

“…This permitted the achievement of a better result, 65% of the patients passing to functional class I with recovery of left ventricular geometry and mechanical function of the mitral valve, as is also reported in the literature 26,28,34,35 . A follow-up period of 16 months showed a survival ratio of 93.8%; other studies, with lower 29 or equal 36 follow-up periods, reported 98% indexes. Studies with follow-up periods of five 26,28 , eight 35 and 16 34 years, reported survival rates of respectively, 90 to 98.8±1.2%, 88±4%, and 76.1±-3.1%.…”

“…This observation led to the proposal of an exclusively posterior prosthesis annuloplasty 26 or of a merely continuous suture, similar to a "De Vega" 25 . Evolution confirmed the superiority of rings for posterior conformation [26][27][28][29][30] .…”

“…They concluded that only an advanced degree of myxomatous alterations was related to a greater risk of reoperation. Cosgrove et al 29 , in a study of patients with predominantly degenerative valve pathology treated with posterior annuloplasty, observed 97% of them to be free of reoperation for a year, and Camilleri et al 28 found 99% of patients to be free of this event for over 5 years. Controversy exists over the reoperation ratio associated with valve repair ou replacement.…”

“…Valve repair techniques using rings are based on the anterior leaflet area, associated or not with intertrigonal or intercommissural distances for the selection of annular prosthesis size 10,13,[27][28][29][30] . In 1985, Braile et al 26 developed specific measuring devices aimed at the evaluation of the anterior cusp perimeter, thus introducing a new concept for the choice of annular prosthesis size.…”