Share this page on LinkedIn
Share This Page on Google+
Share This Page on Twitter
tell someone about this page print this page
You are here: Contents > 2014 > Volume 23 Number 1 January 2014 > MITRAL VALVE DISEASE > Long-Term Results of Mitral Valve Repair with Semi-Rigid Posterior Band Annuloplasty

Long-Term Results of Mitral Valve Repair with Semi-Rigid Posterior Band Annuloplasty

David W. Yaffee, Didier F. Loulmet, Elias A. Zias, Patricia A. Ursomanno, Annette E. Rabinovich, Aubrey C. Galloway, Eugene A. Grossi

Department of Cardiothoracic Surgery, NYU Langone Medical Center, New York, NY, USA

Background and aim of the study: Optimal repair of the mitral valve involves the implantation of an annuloplasty device to geometrically reshape and/or stabilize the annulus and improve long-term durability. It has been reported previously that trigone-to-trigone semi-rigid posterior band (PB) annuloplasty is associated with excellent short-term outcomes, physiologic motion of the anterior mitral annulus and leaflet, and lower postoperative transvalvular gradients compared to complete ring (CR) annuloplasty. The aim of this retrospective study was to compare the long-term effectiveness of PB and CR annuloplasty in patients with degenerative mitral valve regurgitation (MR).

Methods: Between 1993 and 2010, a total of 1,612 patients with degenerative MR underwent mitral valve repair (MVr) with either PB (n = 1,101) or CR (n = 511). Initially, CR was the annuloplasty device of choice, but after 2001 PB was preferred. A retrospective review of clinical and echocardiographic follow up was performed on these patients. The eight-year cumulative freedom from adverse events were determined by life-table analysis.

Results: Hospital mortality was 1.9% overall (n = 30/1612), but 1.3% (12/939) for isolated MVr, and 2.7% (18/673) for MVr with concomitant procedures (p = 0.04). Hospital mortality was similar for both PB (1.9%; 21/1101) and CR (1.8%; 9/511) (p = 0.8). The mean MR grade was reduced from 3.9 ± 0.3 preoperatively to 0.6 ± 0.9 at follow up using PB (p <0.01), and from 3.9 ± 0.4 to 0.9 ± 0.9 using CR (p <0.01). PB was associated with a similar long-term freedom from death (77 ± 0.03% versus 83 ± 0.02%; p = 0.4), reoperation (95 ± 0.01% versus 92 ± 0.01%; p = 0.06), and reoperation or recurrent severe MR (91 ± 0.02% versus 92 ± 0.01%; p = 0.7), and slightly greater freedom from valve-related complications compared to CR (91 ± 0.02% versus 87 ± 0.02%; p = 0.02).

Conclusion: The long-term outcome of mitral valve annuloplasty with PB was comparable to that with CR for degenerative disease. Anterior annuloplasty was found to be unnecessary in this patient population.

The Journal of Heart Valve Disease 2014;23:66-71

Long-Term Results of Mitral Valve Repair with Semi-Rigid Posterior Band Annuloplasty

Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.

Purchase this Article

Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.