title: Midterm results of mitral valve repair: closed versus open annuloplasty ring.
abstract: BACKGROUND
  Closed and open annuloplasty rings are both used for mitral valve repair. This study compared the clinical and echocardiographic results in patients with degenerative mitral disease undergoing MV repair with closed semirigid rings vs open bands.
  
  
  METHODS
  Between 2004 and 2008, 377 patients (mean age, 59 + or - 12 years) underwent mitral valve repair. Valve pathology was degenerative in 273 (72%). Closed rings were used in 163 (60%) and open rings in 110 (40%). Patients had similar characteristics and comorbidities. In addition to annuloplasty, repair techniques included leaflet resection (48% and 77%, p < 0.01), artificial chordal (55% and 36%, p < 0.01), and edge-to-edge repair (4% and 4%, p = 0.79), in closed and open groups, respectively.
  
  
  RESULTS
  One patient in each group died (0.7%). Mean follow-up was 19 + or - 14 (closed group) and 34 + or - 15 months (open group; p < 0.01). Freedom from reoperation was 97.5% (closed group) vs 96.5% (open group). At follow-up, New York Heart Association functional class was similar between groups, and 91% in the closed group and 84% in the open group were free from moderate or severe mitral regurgitation (p = 0.05). Closed group patients had a longer line of leaflet coaptation (9.1 + or - 2.7 mm) vs the open group (7.1 + or - 1.9 mm; p < 0.01).
  
  
  CONCLUSIONS
  Patients with closed semirigid annuloplasty rings demonstrated significantly longer lines of leaflet coaptation and tendency toward better echocardiographic midterm results than patients with open bands and may, therefore, benefit from improved repair durability.
authors.affiliation: Department of Cardiac Surgery, Chaim Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv), Ramat-Gan, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Spiegelstein
authors.forename: Yaron
authors.initials: Y
authors.lastname: Moshkovitz
authors.forename: Leonid
authors.initials: L
authors.lastname: Sternik
authors.forename: Micha S
authors.initials: MS
authors.lastname: Fienberg
authors.forename: Alexander
authors.initials: A
authors.lastname: Kogan
authors.forename: Ateret
authors.initials: A
authors.lastname: Malachy
authors.forename: Ehud
authors.initials: E
authors.lastname: Raanani
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D019736:Prostheses and Implants; D012189:Retrospective Studies; D013997:Time Factors