Prevention of Mitral Ring Dehiscence by a Simple Modification of Suture Placement

Abstract

Ring dehiscence is a serious complication after mitral valve annuloplasty, tending to occur primarily from the posterior annulus. The tension on the ring sutures during the cardiac cycle is one of the suspected reasons; to minimize this tension, we apply four additional pledgeted sutures positioned supra-annularly at critical hinge points and could achieve a marked reduction of annular dehiscence since.

Keywords

mitral valve - surgery - surgical techniques

Publikationsverlauf

Eingereicht: 03. August 2022

Angenommen: 11. Januar 2023

Accepted Manuscript online:
18. Januar 2023

Artikel online veröffentlicht:
27. Februar 2023

• References

• 1 Pierce EL, Bloodworth IV CH, Siefert AW. et al. Mitral annuloplasty ring suture forces: impact of surgeon, ring, and use conditions. J Thorac Cardiovasc Surg 2018; 155 (01) 131.e3-139.e3
• 2 Arjomandi Rad A, Naruka V, Vardanyan R. et al. Mitral and tricuspid annuloplasty ring dehiscence: a systematic review with pooled analysis. Eur J Cardiothorac Surg 2021; 60 (04) 801-810
• 3 Marin-Cuartas M, Noack T. Mitral and tricuspid annuloplasty ring dehiscence, a story yet to be told. Eur J Cardiothorac Surg 2021; 60 (04) 811-812
• 4 Noack T, Kiefer P, Vivell N. et al. Annuloplasty ring dehiscence after mitral valve repair: incidence, localization and reoperation. Eur J Cardiothorac Surg 2020; 57 (02) 300-307
• 5 Pierce EL, Siefert AW, Paul DM. et al. How local annular force and collagen density govern mitral annuloplasty ring dehiscence risk. Ann Thorac Surg 2016; 102 (02) 518-526
• 6 Hassan M, Windsor J, Salerno T, Ricci M. Use of pledgeted sutures in mitral annuloplasty. Innovations (Phila) 2014; 9 (02) 148-149
• 7 Spratt JR, Spratt JA, Lawrie GM. Mitral annuloplasty ring dehiscence: optimal force distribution with flexible rings. J Thorac Cardiovasc Surg 2016; 152 (06) 1639