title: Mitral valve annuloplasty: the effect of the type on left ventricular function.
abstract: This study was undertaken to determine whether rigid-ring annuloplasty and flexible-ring annuloplasty have the same effect on left ventricular function in patients with chronic mitral regurgitation secondary to degenerative disease of the mitral valve. Twenty-five patients who underwent isolated mitral valve repair and required annuloplasty were randomized into two groups: rigid-ring and flexible-ring annuloplasty. Left ventricular function was assessed by echocardiography and radionuclide angiography on the day before operation and 2 to 3 months later. Preoperative left ventricular function was similar in the two groups of patients. Postoperatively, left ventricular end-diastolic diameter and volume decreased significantly in both groups. The left ventricular end-systolic diameter and volume decreased significantly only in patients with a flexible annuloplasty ring. Left ventricular systolic function as assessed by pressure-volume relationships was significantly better in patients with a flexible ring (p less than 0.02 by analysis of covariance), and left ventricular performance measured by stroke volume-end-diastolic volume relationships was also better in these patients (p less than 0.05 by analysis of covariance). These data indicate that patients with a flexible annuloplasty ring have better left ventricular systolic function than patients with a rigid annuloplasty ring 2 to 3 months after mitral valve reconstruction for chronic mitral regurgitation secondary to degenerative disease of the mitral valve.
authors.affiliation: Division of Cardiovascular Surgery, Toronto Western Hospital, Ontario, Canada.
authors.forename: T E
authors.initials: TE
authors.lastname: David
authors.forename: M
authors.initials: M
authors.lastname: Komeda
authors.forename: C
authors.initials: C
authors.lastname: Pollick
authors.forename: R J
authors.initials: RJ
authors.lastname: Burns
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D011897:Random Allocation; D012086:Reoperation