title: Mitral annulus morphologic and functional analysis using real time tridimensional echocardiography in patients submitted to unsupported mitral valve repair.
abstract: BACKGROUND
  Mitral valve repair is the treatment of choice to correct mitral insufficiency, although the literature related to mitral valve annulus behavior after mitral repair without use of prosthetic rings is scarce.
  
  
  OBJECTIVE
  To analyze mitral annulus morphology and function using real time tridimensional echocardiography in individuals submitted to mitral valve repair with Double Teflon technique.
  
  
  METHODS
  Fourteen patients with mitral valve insufficiency secondary to mixomatous degeneration that were submitted to mitral valve repair with the Double Teflon technique were included. Thirteen patients were in FC III/IV. Patients were evaluated in preoperative period, immediate postoperative period, 6 months and 1 year after mitral repair. Statistical analysis was made by repeated measures ANOVA test and was considered statistically significant P<0.05.
  
  
  RESULTS
  There were no deaths, reoperation due to valve dysfunction, thromboembolism or endocarditis during the study. Posterior mitral annulus demonstrated a significant reduction in immediate postoperative period (P<0.001), remaining stable during the study, and presents a mean of reduction of 25.8% comparing with preoperative period. There was a significant reduction in anteroposterior and mediolateral diameters in the immediate postoperative period (P<0.001), although there was a significant increase in mediolateral diameter between immediate postoperative period and 1 year. There was no difference in mitral internal area variation over the cardiac cycle during the study.
  
  
  CONCLUSIONS
  Segmentar annuloplasty reduced the posterior component of mitral annulus, which remained stable in a 1-year-period. The variation in mitral annulus area during cardiac cycle remained stable during the study.
authors: Instituto do Coração do Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, BR.
authors: Marco Antônio Vieira
authors: MA
authors: Guedes
authors: Instituto do Coração do Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, BR.
authors: Pablo Maria Alberto
authors: PM
authors: Pomerantzeff
authors: Instituto do Coração do Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, BR.
authors: Carlos Manuel de Almeida
authors: CM
authors: Brandão
authors: Instituto do Coração do Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, BR.
authors: Marcelo Luiz Campos
authors: ML
authors: Vieira
authors: Instituto do Coração do Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, BR.
authors: Flávio
authors: F
authors: Tarasoutchi
authors: Instituto do Coração do Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, BR.
authors: Pablo da Cunha
authors: Pda C
authors: Spinola
authors: Instituto do Coração do Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, BR.
authors: Fábio Biscegli
authors: FB
authors: Jatene
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000503:physiopathology; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D009929:Organ Size; D059035:Perioperative Period; D012016:Reference Values; D013997:Time Factors; D016896:Treatment Outcome