Comparison of flexible, open with semi-rigid, closed annuloplasty-rings for mitral valve repair

J Cardiothorac Surg. 2021 Mar 20;16(1):35. doi: 10.1186/s13019-021-01405-1.

Abstract

Background: Mitral regurgitation is a frequent valvular disease, with an increasing prevalence. We analysed the long-term outcomes of mitral valve repair procedures conducted over the last 10 years in our clinic using almost exclusively two different annuloplasty ring types.

Methods: A single-centre, retrospective analysis of mitral valve surgeries conducted between January 2005 and December 2015 for patients undergoing first-line mitral valve repair with either open (Cosgrove) or closed (CE Physio / Physio II) annuloplasty (OA or CA, respectively) rings.

Results: In total, 1120 patient documentations were available of which 528 underwent OA and 592 patients CA. The median age of patients was 64.0 years and 41.1% were female. The majority of these patients underwent the procedure because of degenerative valve disease. Rates of successful repair were about 90%, 72 h procedural mortality was 0.6% and the rate of re-intervention was 0.6% within the first 30 days. Functional (mitral regurgitation, left ventricular ejection fraction, left ventricular end-diastolic and systolic diameter and New York Heart Association class) as well as hard outcomes were comparable. 77.7 and 74.4% of patients were alive at the 10-year follow-up in the OA and CA groups, respectively. Upon multivariable adjustment, the hazard ratio was 0.926 (95% CI: 0.642-1.3135; p = 0.681).

Conclusions: The functional outcome and survival rates up to 10 years after mitral valve repair were comparable using open and closed annuloplasty rings. Whether this means these rings are interchangeable or a carefully selection of the best-for-the-patient devices will be subject of future investigations.

Keywords: Annuloplasty; Closed ring; Mitral regurgitation; Mitral valve repair; Open ring.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / surgery*
  • Mitral Valve Annuloplasty / instrumentation*
  • Mitral Valve Annuloplasty / methods*
  • Mitral Valve Insufficiency / surgery*
  • Proportional Hazards Models
  • Retrospective Studies
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Function, Left*