Septal-Lateral Annular Cinching (’SLAC“) reduces Mitral Annular Size without Perturbing Normal Annular Dynamics
Tomasz A. Timek MD, David T. Lai FRACS, Frederick A. Tibayan MD, George T. Daughters MS, David Liang MD, PhD, Paul Dagum MD, Neil B. Ingels, Jr. PhD, D. Craig Miller MD

Ring annuloplasty is often used in mitral valve repair to enhance leaflet coaptation and stabilize the repair; however, the rings adversely affect mitral annular and leaflet dynamic motion. Annular and leaflet three-dimensional dynamics were investigated after using a novel technique to reduce annular size, septal-lateral annular cinching (’SLAC“), in a sheep model. SLAC achieved the same extent of septal-lateral annular reduction as do annuloplasty rings, yet allowed normal mitral annular dynamic motion. Moreover, posterior leaflet mobility was only slightly impaired. SLAC potentially represents a more physiologic alternative to annuloplasty rings for correcting certain forms of functional mitral regurgitation.