Dehiscence of Surgical Annuloplasty Rings and Bands after Mitral Valve Repair: Incidence, Localization, and Clinical Outcome after Redo Surgery

Objectives: In patients who have underwent mitral valve (MV) repair with ring or band annuloplasty, dehiscence of annuloplasty ring or band is well-known complication after MV repair. Incidence, localization of dehiscence, and clinical outcome after redo surgery are unknown.

Methods: From 1997 to 2015, 4,178 patients underwent isolated MV repair at the Heart Center Leipzig. These patients were retrospectively screened for reoperation due to dehiscence of annuloplasty ring or band. Echocardiographic data after initial MV repair and clinical outcome after redo surgery were analyzed.

Results: From 4,178 patients, 57 patients (1.4%) presented a dehiscence of annuloplasty ring or band after initial MV repair. The mostly dehiscence were found in segment P3 (68.4%), followed by P2 (50.9%) and P1 (47.4%). Acute (< 30 days), early (<1 year), and late (>1 year) dehiscence were found in 43.9, 33.3, and 22.8%, respectively. Thirty-day, 1-, and 5-year survival after redo surgery were 2, 89, and 74%, respectively. During redo surgery, MV replacement was performed in 35 (61.4%), and MV repair was performed in 22 (38.6%) patients.

Conclusion: Dehiscence of annuloplasty rings and bands is a very rare complication after MV repair. Redo surgery is safe and can be performed with slightly increased 30-day mortality and slightly decreased 1- and 5-year survival compared with initial MV repair.

No conflict of interest has been declared by the author(s).