title: Mitral valve repair with Carpentier-McCarthy-Adams IMR ETlogix annuloplasty ring for ischemic mitral regurgitation: early echocardiographic results from a multi-center study.
abstract: BACKGROUND
  Ischemic mitral regurgitation (IMR) is associated with asymmetric changes in annular and ventricular geometry. Surgical repair with standard symmetric annuloplasty rings results in a high incidence of residual or recurrent mitral regurgitation (MR). The Carpentier-McCarthy-Adams (CMA) IMR ETlogix annuloplasty ring is the first remodeling ring specifically designed to treat asymmetric leaflet tethering and annular dilatation. We used quantitative 2-dimensional echo to examine early results of mitral valve (MV) repair with the CMA IMR ETlogix annuloplasty ring in patients with IMR.
  
  
  RESULTS
  Fifty-nine patients (aged 68+/-12 years) with grade > or = 2+ IMR (graded on a scale of 0 to 4+) underwent MV repair with the CMA IMR ETlogix annuloplasty ring. We assessed the mitral annular diameter (MAD), tethering area (TA), and tenting height (TH) of the MV in 4-chamber, 2-chamber, and long axis views at mid-systole before and 3 to 10 days after surgery. After surgery, 57 of 59 (97%) patients had grade 0 or 1+ MR, whereas 2 patients had 2+ MR. MV repair with the CMA IMR ETlogix ring significantly reduced MAD, TA, and TH (P<0.001, for all 3 echo views), particularly in the long axis and 4-chamber views.
  
  
  CONCLUSIONS
  Surgical repair of IMR with the novel asymmetric CMA IMR ETlogix annuloplasty ring provided excellent early results with effective reduction of MR, MAD, and leaflet tethering. This novel etiology-specific strategy may result in improved outcomes in IMR patients.
authors.affiliation: Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
authors.forename: Masao
authors.initials: M
authors.lastname: Daimon
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.forename: David H
authors.initials: DH
authors.lastname: Adams
authors.forename: Patrick M
authors.initials: PM
authors.lastname: McCarthy
authors.forename: A Marc
authors.initials: AM
authors.lastname: Gillinov
authors.forename: Alain
authors.initials: A
authors.lastname: Carpentier
authors.forename: Farzan
authors.initials: F
authors.lastname: Filsoufi
authors.forename: Vivian M
authors.initials: VM
authors.lastname: Abascal
authors.forename: Vera H
authors.initials: VH
authors.lastname: Rigolin
authors.forename: Sacha
authors.initials: S
authors.lastname: Salzberg
authors.forename: Anna
authors.initials: A
authors.lastname: Huskin
authors.forename: Michelle
authors.initials: M
authors.lastname: Langenfeld
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shiota
mesh_terms: D000368:Aged; D000886:Anthropometry; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D009203:Myocardial Infarction / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology; D019736:Prostheses and Implants; D012189:Retrospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome