The Puig-Massana-Shiley Annuloplasty Ring for Mitral Valve Repair: Experience in 126 Patients

Murphy, J. Peter; Sweeney, Michael S.; Cooley, Denton A.

doi:10.1016/s0003-4975(10)60166-x

Cited by 24 publications

(3 citation statements)

References 14 publications

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“…These circumstances generally favor valve replacement rather than repair. 28 From our experience, it appears that mitral valve repair can be done in 80% of patients with the Marfan syndrome who undergo mitral valve procedures. Others have found a similar proportion of reparable valves among patients with degenerative mitral valve disease.P: 27,29 As noted earlier, advantages of mitral valve repair over replacement include preservation of the subvalvular apparatus and a lower risk of endocarditis.P: 27, 29, 31 In addition, those patients who underwent isolated mitral valve repair or combined mitral valve repair and replacement of the aortic root with homograft (total of seven patients) were spared long-term anticoagulation.…”

Section: Discussionmentioning

confidence: 91%

Mitral valve operation in patients with the Marfan syndrome

Gillinov¹,

Hulyalkar²,

Cameron³

et al. 1994

The Journal of Thoracic and Cardiovascular Surgery

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Optimal surgical treatment of mitral regurgitation in the Marfan syndrome (valve repair versus replacement) is controversial because the underlying connective tissue defect theoretically might compromise repair durability. To examine the results of mitral valve repair in these patients, we did a retrospective review of 160 patients with the Marfan syndrome who had cardiac surgical procedures between January 1983 and January 1993. Thirty-six patients had mitral procedures, 29 of which were repairs. Mitral valve replacement was necessary in seven patients because of extensive annular calcification and/or severe anterior leaflet abnormalities. The 18 men and 11 women undergoing mitral valve repair had a mean age of 26.5 ± 2.6 years (range 9 months to 54 years); seven patients were less than 18 years of age. Twenty-four of the 29 patients had concomitant aortic root replacement because of aortic dilation or valvular insufficiency. AU 29 repairs included annuloplasty, and 11 patients also required leaflet resection. There were no operative deaths. At mean follow-up of 26.6 ± 4.8 months, there have been three late deaths, two caused by arrhythmia and one by complications of type m aortic dissection. All survivors are in New York Heart Association class I or II. In three patients recurrent mitral regurgitation developed (grade m or IV); 5-year actuarial freedom from significant mitral regurgitation was 88.3 %. One patient required repeat mitral annuloplasty after endocarditis of the composite aortic graft spread to the mitral valve. No patient required late mitral valve replacement. These results demonstrate that (1) 22 % of patients with the Madan syndrome who undergo cardiac operation require a mitral valve procedure, (2) most can be treated by mitral repair rather than replacement, and (3) at early follow-up, results of mitral repair in this population are satisfactory. (J

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Section: Discussionmentioning

confidence: 91%

Mitral valve operation in patients with the Marfan syndrome

Gillinov¹,

Hulyalkar²,

Cameron³

et al. 1994

The Journal of Thoracic and Cardiovascular Surgery

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“…Contribuíram, também, para isso as conhecidas complicações decorrentes da troca valvar, como degeneração de biopróteses, infecções, gradientes transvalvares, vazamento paravalvar, hern6lise e eventos tromboembólicos. MURPHY Jr. el alii 31 insistem em afirmar que o sucesso do emprego dessa técnica, hoje amplamente utilizada, depende da experiência de sua aplicação.…”

Section: Discussionunclassified

Plástica mitral

Braile¹,

Ardito²,

Pinto³

et al. 1990

Rev Bras Cir Cardiovasc

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RESUMO : Foram estudados 101 pacientes submetidos a plástica da valva mitral em seis anos, com seguimento de 100%. Entre eles, 36 eram do sexo masculino e 65 do sexo feminino, com idade variando de dois a 62 anos (M = 28 ± 16,4). Desses, 57 (56,4%) foram submetidos apenas a abordagem valvar mitral. Os demais foram submetidos a procedimentos associados, como plástica tricúspide (9,9%), revascularização do miocárdio (4,0%), entre outros. Não foi registrado óbito imediato. O índice de mortalidade tardia foi de 2% (AVC hemorrágico após cinco anos e septicemia), no primeiro ano. As complicações não fatais foram representadas pela endocardite evidenciada em dois pacientes (2%), sendo tratados e curados, e um paciente com reestenose mitral pós-plástica por reagudização da doença reumática. O estudo atuarial revelou um índice de 79,0 ± 17,7% de sobrevida, um total de 76,3 ± 17,8% de pacientes livres de complicações, 80,0 ± 17,9% de reoperações, 100,0% livres de tromboembolismo. Os resultados ecodoplercardiográficos registraram que 89% dos pacientes evoluíram com ausência de insuficiência. Dos 11 % restantes, 7,4% apresentram insuficiência mitral discreta, 2,4% moderada e 2% importante. De acordo com a classificação da NYHA, os pacientes das classes III (83,8%) e IV (16,2%) passaram para as classes I (33,3%), II (60,6%), III (4,1%) e IV (2%). Os autores concluem que o anel de pericárdiO flexível conforma-se perfeitamente com o anel valvar, não produz hemólise e se endoteliza completamente a médio prazo. DESCRITORES: valva mitral, plastia; próteses valvulares cardíacas, biológicas, cirurgia.

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“…A series of prostheses were developed aiming at adjusting the annular constriction after their implantation as well as allowing the functional movement of the contraction of the mitral annulus which include the prostheses of Puig-Massana [29], Abdulmassih [30], Shumway [31], Sculptor [32] and St.Jude-Biflex [33].…”

Section: Flexible Prosthesismentioning

confidence: 99%