Mitral valve remodeling: Long-term results with posterior pericardial annuloplasty

Scrofani, Roberto; Moriggia, Stefano; Salati, Maurizio; Fundarò, P; Danna, Paolo; Santoli, C

doi:10.1016/0003-4975(95)01139-0

Cited by 37 publications

(21 citation statements)

References 15 publications

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“…Chordal-sparing mitral valve replacement, 11 Carpentier's mitral repair techniques, 12 flexible ring annuloplasty, 13 suture, 8 and pericardial strip 14 Paneth suture annuloplasty abolished acute IMR in this study by decreasing septal-lateral and commissurecommissure annular diameters. Septal-lateral annular dilation has been shown to be the principal cause of leaflet malcoap- S-L maxϭmaximum septal-lateral annular diameter; S-L minϭminimum septal-lateral annular diameter; C-C maxϭmaximum commissure-commissure diameter; C-C minϭminimum commissurecommissure diameter; FϭF value from repeated measures ANOVA.…”

Section: Discussionmentioning

confidence: 74%

Paneth Suture Annuloplasty Abolishes Acute Ischemic Mitral Regurgitation but Preserves Annular and Leaflet Dynamics

Tibayan

Rodriguez²,

Liang³

et al. 2003

Circulation

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Background-Ring annuloplasty, the standard treatment for ischemic mitral regurgitation (IMR), abolishes normal annular dynamics and freezes the posterior leaflet. We examined the impact of Paneth suture annuloplasty during acute IMR on motion of the mitral annulus and leaflets in an ovine model. Methods and Results-Eight sheep had radiopaque markers placed on the left ventricle, anterior mitral leaflet, posterior mitral leaflet, and mitral annulus. A Paneth suture annuloplasty that could be reversibly tightened was anchored to each fibrous trigone and externalized through the mid-lateral mitral annulus. Acute IMR was induced by proximal circumflex artery occlusion. Transesophageal echocardiography assessed the degree of IMR, and biplane cinefluoroscopy measured 3-dimensional marker coordinates before and during circumflex ischemia, and tightening of the Paneth suture. Paneth suture annuloplasty eliminated acute IMR, and reduced septal-lateral and commissure-commissure mitral annular dimensions. Tightening of the annuloplasty sutures, even beyond the degree necessary to eliminate mitral regurgitation (MR), did not reduce septal-lateral or commissure-commissure annular shortening, shortening of the muscular annular perimeter, annular flexion, or angular excursion of the anterior or posterior leaflets relative to ischemic conditions. Conclusions-In contrast to ring annuloplasty, annular reduction sufficient to restore mitral competence during acute IMR can be achieved with a Paneth suture annuloplasty while simultaneously maintaining normal annular and leaflet dynamic motion. These findings should prompt additional investigation and design of repair methods that preserve the mobility of the mitral apparatus.

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Section: Discussionmentioning

confidence: 74%

Paneth Suture Annuloplasty Abolishes Acute Ischemic Mitral Regurgitation but Preserves Annular and Leaflet Dynamics

Tibayan

Rodriguez²,

Liang³

et al. 2003

Circulation

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“…Annuloplasty with pericardial tissue was introduced by Slati et al 15 There are diverging opinions about its suitability for annulus reinforcement. [15][16][17][18][19] Some studies reported PeMA to be superior to PrMA in terms of preserving annulus physiological dynamics. Bevilacqua et al compared posterior PeMA to posterior PrMA in patients with degenerative MR (with/without CAD).…”

Section: Discussionmentioning

confidence: 99%

A second look at autopericardial mitral annuloplasty

Sidiki¹,

Faybushevich²,

Лищук³

2020

Cor Vasa

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Please cite this article as: Sidiki AI, Faybushevich AG, Lishchuk AN. A second look at autopericardial mitral annuloplasty. Cor Vasa 2020;62:37-43. ARTICLE INFO SOUHRNCíl: Srovnat totální anuloplastiku s použitím perikardu (pericardial annuloplasty, PeMA) s totální anuloplastikou s použitím protetického prstence (prosthetic annuloplasty, PrMA) z hlediska trvanlivosti v léčbě degenerativní, ischemické i neischemické funkční mitrální regurgitace (MR). Metody: Zpětně jsme zkontrolovali prospektivně shromažďované údaje 280 pacientů, u nichž byla v letech 2008 až 2015 po valvuloplastice provedena buď PeMA (50,4 %), nebo PrMA (s použitím anuloplastických prstenců Carpentier-Edwards Physio; 49,6 %). Mezi kombinované výkony patřily: 40× CABG (PeMA -18, PrMA -22); 13× ablace spolu s odstraněním ouška levé síně (PeMA -8, PrMA -5); 7× plastika mitrální chlopně (PeMA -2, PrMA -5); 9× uzávěr defektu septa síní (PeMA -3, PrMA -6). Výsledky: Třicetidenní mortalita činila 0,4 %. Průměrná délka sledování skončila v 95,7 % případů po 83,4 ± 13,0 měsících. Výkony byly v sedmiletém horizontu srovnatelné: nulová nutnost reoperace a recidiva MR = 2+/3+ (PeMA 96,3 %; PrMA 96,4 %; p = 0,914); nepřítomnost komplikací (PeMA 86,5 %; PrMA 89,2 %; p = 0,174); přežití (PeMA 96,5 %; PrMA 97,8 %; p = 0,238). Celkové sedmileté přežití dosáhlo hodnoty 97,1 %. Podle multivariační analýzy byly vysoký věk a ischemická choroba srdeční = 2+/3+ (p = 0,027; HR = 1,131, resp. p = 0,030; HR = 2,002) významnými prediktory reoperace a recidivy MR i nezávislými predikčními faktory kratšího přežití (p = 0,029; HR = 4,251, resp. p = 0,040; HR = 1,135). V multivariační analýze vysoká hodnota ejekční frakce levé komory negativně korelovala s nižším rizikem reoperace a recidivy MR = 2+/3+ (p = 0,006; HR = 0,786) a příznivější délkou přežití (p = 0,013; HR = 0,718). Závěry: Při dobře provedené valvuloplastice může mít perikardiální prstenec stejnou trvanlivost jako prstenec Physio a při použití dokonalejších metod fi xace může být trvanlivost i delší. Pokud se týče ceny, představuje perikardiální prstenec lepší volbu, protože nestojí nic, zatímco cena prstence Physio je přibližně 600 USD. Protetické prstence nejsou vždy spojeny s rozvojem endokarditidy, tromboembolie, kalcifi kace chlopně ani hemolytickou anémií. ABSTRACTObjective: To compare total pericardial mitral annuloplasty (PeMA) and total prosthetic mitral annuloplasty (PrMA) in terms of durability in the treatment of degenerative, ischemic functional and non-ischemic functional mitral regurgitation (MR). Methods: We retrospectively reviewed prospectively collected data of 280 patients who received either PeMA (50.4%) or PrMA (with Carpentier-Edwards Physio rings; 49.6%) after valvuloplasty between 2008 and 2015. Combined procedures included: 40 CABG (PeMA -18, PrMA -22); 13 ablations with left atrial appendectomy (PrMA -8, PrMA -5); 7 tricuspid valve repairs (PeMA -2, PrMA -5); 9 closures of atrial septal defect (PeMA -3, PrMA -6). Results: Thirty-day mortality was 0.4%. Mean follow-up was 95.7% complete ...

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“…Impaired diastolic annular dynamics and hampered exercise-related increase in left ventricular ejection fraction can occur when a rigid ring is employed [32,33]. Calcification of the pericardium, when utilized for the posterior annuloplasty is a possible event [34,35]. …”

Section: Discussionmentioning

confidence: 99%

Rest and Dobutamine stress echocardiography in the evaluation of mid-term results of mitral valve repair in Barlow's disease

Minardi

Manzara

Pulignano

et al. 2007

Cardiovasc Ultrasound

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Background: Surgical "anatomical" repair is the most frequent technique used to correct mitral regurgitation due to severe myxomatous valve disease. Debate, however, persists on the efficacy of this technique, as well as on the durability of the repaired valve, and on its functioning and hemodynamics under stress conditions. Thus, a basal and Dobutamine echocardiographic (DSE) study was carried out to evaluate these parameters at mid-term follow-up.

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Mitral valve remodeling: Long-term results with posterior pericardial annuloplasty

Cited by 37 publications

References 15 publications

Paneth Suture Annuloplasty Abolishes Acute Ischemic Mitral Regurgitation but Preserves Annular and Leaflet Dynamics

Paneth Suture Annuloplasty Abolishes Acute Ischemic Mitral Regurgitation but Preserves Annular and Leaflet Dynamics

A second look at autopericardial mitral annuloplasty

Rest and Dobutamine stress echocardiography in the evaluation of mid-term results of mitral valve repair in Barlow's disease

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