Is a Profiled Annuloplasty Ring Suitable for Repair of Degenerative Mitral Regurgitation? A Single-Center Experience Comprising 200 Patients

Abstract

Background Various devices have been proposed for ring annuloplasty in patients with degenerative mitral valve disease. This study reports for the first time midterm results with the rigid three-dimensional Medtronic Profile 3D (Medtronic, Minneapolis, Minnesota, United States) annuloplasty ring. Methods Between June 2009 and June 2011, 200 patients (mean age 61 ± 13 years, 70% male) with severe degenerative mitral regurgitation underwent mitral valve repair using the Medtronic Profile 3D annuloplasty ring. A total of 106 patients (53.0%) underwent isolated mitral valve repair and 94 patients (47.0%) underwent a concomitant procedure such as coronary artery bypass grafting (n = 21), tricuspid valve surgery (n = 49), AF ablation (n = 17), and aortic valve surgery (n = 13). The follow-up is 94.5% complete (mean 2.5 ± 0.5 years). Results Thirty-day mortality was 1.5%. Survival at 3 years was 97.1 ± 1.6% for isolated procedures and 92.4 ± 2.8% for combined procedures (p = 0.137). Freedom from mitral valve-related reoperation at 3 years was 97.1 ± 1.7% for isolated procedures and 95.5 ± 2.2% for combined procedures (p = 0.561). Seven patients (3.5%) required a mitral valve-related reoperation. Two of these reoperations were required for endocarditis, two for ring dehiscence, one for progression of the native disease (flail leaflet), one for leaflet suture dehiscence, and one for persistent systolic anterior motion. Conclusion The three-dimensional Medtronic Profile 3D annuloplasty ring is suitable for mitral valve repair for degenerative diseases. This saddle-shaped annuloplasty device provides excellent early results with a very good functional outcome at midterm either in isolated or combined procedures.

Mitral and tricuspid annuloplasty ring dehiscence: a systematic review with pooled analysis

“…Among the mitral studies, 6 used semi-rigid [ 6 , 7 , 9 , 13 , 20 , 27 ], 5 used rigid [ 10 , 13 , 14 , 18 , 24 ], 5 used flexible [ 8 , 11 , 12 , 19 , 27 ] and 2 used biological rings [ 17 , 25 ]. The incidence of dehiscence among ring types was the following: 0.04% flexible; 1.55% semi-rigid; 2.96% rigid and 3.07% in biological (number of patients, respectively: 784; 3750; 608; 163).…”

Functional Mitral Valve Regurgitation: Mitral Valve Repair or Replacement? Our “Road Map” for the Appropriate Strategy

“…In addition, we observed a low reoperation rate due to recurrent MR in patients undergoing MV repair for functional MR. At latest follow-up, no patient presented with more than moderate mitral regurgitation. In previous studies from our institution, we have demonstrated that MV repair for functional MR was associated with low or no recurrent MR [ 10 , 11 , 12 ]. These findings resonate with prior evidence suggesting that high rates of recurrent MR may attenuate the potential benefits of mitral valve repair [ 2 , 3 , 13 , 14 , 15 ].…”