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You are here: Contents > 2013 > Volume 22 Number 6 November 2013 > INFECTIVE ENDOCARDITIS > Competent Mitral Valve after Annulus Ring Removal for Infective Endocarditis

Competent Mitral Valve after Annulus Ring Removal for Infective Endocarditis

Leandro Slipczuk1,2, Alfredo Trento2, Huai Luo2, Robert J. Siegel2

1Department of Medicine, Einstein Medical Center. Philadelphia, PA, 2Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

The mitral annulus plays an essential role in mitral valve (MV) competency. When surgical intervention is needed, the placement of an annular ring is considered a major component of MV repair. However, the use of a foreign material increases the risk of infectious and thromboembolic complications and is problematic in children as it does not allow for annular growth. Herein is reported a case of infective endocarditis affecting a mitral ring that was implanted to treat severe mitral valve regurgitation (MR) some 10 years earlier. Surgery was performed to remove the MV vegetation, and subsequent echocardiography revealed only trace MR. The concept that the ring may be needed for a limited period of time to induce valve

remodeling is consistent with new data on biodegradable rings. These rings degrade over months, inducing dense fibrous tissue that replaces the ring and maintains valve competency. The present case is one of the first human examples to support the potential efficacy of a biodegradable ring.

Video 1: Insignificant mitral regurgitation after removal of the annular ring. Transesophageal long-axis basal view at 133° with Doppler, showing only trace mitral regurgitation after annular ring removal. [click here to view]

The Journal of Heart Valve Disease 2013;22:843-845

Competent Mitral Valve after Annulus Ring Removal for Infective Endocarditis

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