Thorac cardiovasc Surg
DOI: 10.1055/s-0039-1696989
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Functional and Degenerative Mitral Regurgitation: One Ring Fits All?

Konstantinos Sideris
1  Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
2  Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universität München, Munich, Germany
,
Johannes Boehm
1  Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
2  Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universität München, Munich, Germany
,
Bernhard Voss
1  Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
2  Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universität München, Munich, Germany
,
Thomas Guenther
1  Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
2  Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universität München, Munich, Germany
,
Ruediger S. Lange
1  Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
2  Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universität München, Munich, Germany
,
Ralf Guenzinger
1  Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
2  Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universität München, Munich, Germany
› Author Affiliations
Funding This study was supported by Medtronic. The funding supported echocardiography facilities and research staff.
Further Information

Publication History

01 March 2019

05 August 2019

Publication Date:
23 September 2019 (online)

Abstract

Background Three-dimensional saddle-shaped annuloplasty rings have been shown to create a larger surface of leaflet coaptation in mitral valve repair (MVR) for functional mitral regurgitation (FMR) and degenerative mitral regurgitation (DMR) which may increase repair durability. For the first time, this study reports mid-term results after MVR for DMR and FMR using a rigid three-dimensional ring (Profile 3D, Medtronic).

Methods Between June 2009 and June 2012, 369 patients with DMR (n = 326) or FMR (n = 43) underwent MVR (mean age 62.3 ± 12.6 years). A total of 205 patients (55.6%) underwent isolated MVR and 164 patients (44.4%) a combined procedure. Follow-up examinations were performed in 94.9% (mean 4.9 ± 0.9 years). Echocardiographic assessment was complete in 93.2% (mean 4.3 ± 1.2 years).

Results The 30-day mortality was 1.5% (5/326) for DMR (1.5% for isolated and 1.6% for combined procedures) and 9.3% (4/43) for FMR (0% for isolated and 10.5% for combined procedures). Survival at 6 years was 92.1 ± 1.9% for DMR (92.9 ± 2.6% for isolated and 90.7 ± 2.7% for combined procedures) and 66.4 ± 7.9% for FMR (80.0 ± 17.9% for isolated and 63.7 ± 8.9% for combined procedures). Cumulative risk for mitral valve-related reoperation at 6 years was 0% for FMR and 7.1 ± 1.5% for DMR. At echocardiographic follow-up, one patient presented with mitral regurgitation (MR) more than moderate. The only predictor of recurrent MR after MVR for DMR was residual mild MR at discharge.

Conclusion Repair of FMR with the three-dimensional Profile 3D annuloplasty ring shows excellent mid-term results with regard to recurrence of MR. In cases of DMR, the results are conforming to the current literature.

Meeting Presentation

This study was presented at the 46th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery (DGTHG), Leipzig, February 11–14, 2017.


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