Authors
Sidiki A.I.1, 2, Lishchuk A.N.2, Fajbushevich A.G.1
1 People’s Friendship University of Russia, Moscow
2 FSBI «3 Central Vishnevsky Military Hospital of the Defense of the Russian Federation» vil. Novy-hospital, p/b Arkhangelskoe, Krasnogorsk district, Moscow region
Abstract
Background: for the past several decades, valve repair has become the standard method of treating mitral valve insufficiency because it improves left ventricular geometry and function and increases long-term patient survival. Stabilizing the mitral annulus with a ring is an integral part of mitral valve reconstruction. There have been several discussions and arguments about the advantages and disadvantages of the many available annuloplasty devices.
Aims: we compared the early and long-term results of mitral valve reconstruction with rigid and semi-rigid annuloplasty rings in degenerative disease.
Materials and methods: between January 2015 and December 2019, 152 were randomized into one of the two groups of repair of degenerative mitral valves: group RR- mitral valve repair with a rigid annuloplasty ring (76 patients), group SR- mitral valve repair with a semi-rigid annuloplasty ring (76 patients). The patients’ mean age was 58.7±9.0 in RR and 62.5±8.9 years in SR. The groups did not differ in terms of sex, age, height, weight, preoperative NYHA functional class and cardiac rhythm.
Results: two patients in group RR who underwent valve replacement due to initial repair failure were excluded from the study. There were 3 instances of hospital mortality. The mean follow-up time was 59.4±6.1 months. In both groups, left ventricular ejection fraction, end diastolic volume, stroke volume, left ventricular and left atrial sizes were significantly reduced in the early postoperative period as compared to the preoperative values. The groups had similar characteristics, preoperative and long-term cardiac parameters. At 5-years of follow-up, recurrent mitral regurgitation was of grade 1.0±0.5 and 1.0±0.7 in RR and SR respectively. Freedom from redo surgery was 97.3% in RR and 100% in SR, from recurrent regurgitation ≥2/4 was 74.3% in RR and 69.75% in SR. Survival was 98.6% and 97.4 in RR and SR respectively. There were no instances of myocardial infarction, stroke, hemorrhage, infective endocarditis and any kind of thromboembolic event. Only two patients in RR had documented repair failure.
Conclusions: we found out in this study that mitral valve reconstruction with rigid and semi-rigid annuloplasty rings have comparable early and long-term clinical and echocardiographic results.
Keywords: mitral regurgitation, mitral valve repair, rigid ring, semi-rigid ring.
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