Early results of a simplified method of mitral valve annuloplasty

J. A. Odell, Hartzell V Schaff, T. A. Orszulak

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: We hypothesized that a simple, unmeasured posterior annuloplasty technique (two thirds of a 27-mm Duran ring) offered advantages of standardization and ease of insertion. Methods and Results: A consecutive series of all patients (n=418; median age, 67 years) having mitral valve repair performed by two surgeons was analyzed to determine the outcome of three different annuloplasty techniques: commissural annuloplasty (n=124), complete ring annuloplasty (n=113), and an unmeasured, posterior, partial ring annuloplasty (n=181). Intraoperatively, before repair, severity of mitral regurgitation as measured by double sampling dye curves and transesophageal echocardiography was similar in all three groups; after mitral valve repair, intraoperative assessment showed a similar degree of reduction in regurgitation in the three annuloplasty groups. Before hospital dismissal, transthoracic echocardiography demonstrated that tire mean mitral valve areas and gradients were similar in the three groups; more patients having commissural annuloplasty were classified as having grade II or greater regurgitation. Mortality (n=7, 1.7%) and need for reoperation (n=8, 1.9%) was low in all groups despite the fact thai additional procedures were per formed in 48.8% of patients. Durations of cardiopulmonary bypass and aortic cross- clamping were significantly less in patients having commissural or posterior annuloplastics compared with those receiving a complete ring annuloplasty. Conclusions: These early results indicate that the posterior annuloplasty method is reproducible and expeditious. Postoperative valve function as assessed by degree of regurgitation, transvalvular gradient, and valve area was similar to thai obtained by measured, complete ring annuloplasty and superior to that found in patients having commissural annuloplasty.

Original languageEnglish (US)
JournalCirculation
Volume92
Issue number9 SUPPL.
StatePublished - 1995

Fingerprint

Mitral Valve Annuloplasty
Mitral Valve
Transesophageal Echocardiography
Mitral Valve Insufficiency
Cardiopulmonary Bypass
Reoperation
Constriction
Echocardiography
Coloring Agents
Mortality

Keywords

  • mitral valve
  • surgery
  • valvuloplasty

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Early results of a simplified method of mitral valve annuloplasty. / Odell, J. A.; Schaff, Hartzell V; Orszulak, T. A.

In: Circulation, Vol. 92, No. 9 SUPPL., 1995.

Research output: Contribution to journalArticle

Odell, JA, Schaff, HV & Orszulak, TA 1995, 'Early results of a simplified method of mitral valve annuloplasty', Circulation, vol. 92, no. 9 SUPPL..
Odell, J. A. ; Schaff, Hartzell V ; Orszulak, T. A. / Early results of a simplified method of mitral valve annuloplasty. In: Circulation. 1995 ; Vol. 92, No. 9 SUPPL.
@article{5334a9f0a26c4fa18966f93f8dccc068,
title = "Early results of a simplified method of mitral valve annuloplasty",
abstract = "Background: We hypothesized that a simple, unmeasured posterior annuloplasty technique (two thirds of a 27-mm Duran ring) offered advantages of standardization and ease of insertion. Methods and Results: A consecutive series of all patients (n=418; median age, 67 years) having mitral valve repair performed by two surgeons was analyzed to determine the outcome of three different annuloplasty techniques: commissural annuloplasty (n=124), complete ring annuloplasty (n=113), and an unmeasured, posterior, partial ring annuloplasty (n=181). Intraoperatively, before repair, severity of mitral regurgitation as measured by double sampling dye curves and transesophageal echocardiography was similar in all three groups; after mitral valve repair, intraoperative assessment showed a similar degree of reduction in regurgitation in the three annuloplasty groups. Before hospital dismissal, transthoracic echocardiography demonstrated that tire mean mitral valve areas and gradients were similar in the three groups; more patients having commissural annuloplasty were classified as having grade II or greater regurgitation. Mortality (n=7, 1.7{\%}) and need for reoperation (n=8, 1.9{\%}) was low in all groups despite the fact thai additional procedures were per formed in 48.8{\%} of patients. Durations of cardiopulmonary bypass and aortic cross- clamping were significantly less in patients having commissural or posterior annuloplastics compared with those receiving a complete ring annuloplasty. Conclusions: These early results indicate that the posterior annuloplasty method is reproducible and expeditious. Postoperative valve function as assessed by degree of regurgitation, transvalvular gradient, and valve area was similar to thai obtained by measured, complete ring annuloplasty and superior to that found in patients having commissural annuloplasty.",
keywords = "mitral valve, surgery, valvuloplasty",
author = "Odell, {J. A.} and Schaff, {Hartzell V} and Orszulak, {T. A.}",
year = "1995",
language = "English (US)",
volume = "92",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "9 SUPPL.",

}

TY - JOUR

T1 - Early results of a simplified method of mitral valve annuloplasty

AU - Odell, J. A.

AU - Schaff, Hartzell V

AU - Orszulak, T. A.

PY - 1995

Y1 - 1995

N2 - Background: We hypothesized that a simple, unmeasured posterior annuloplasty technique (two thirds of a 27-mm Duran ring) offered advantages of standardization and ease of insertion. Methods and Results: A consecutive series of all patients (n=418; median age, 67 years) having mitral valve repair performed by two surgeons was analyzed to determine the outcome of three different annuloplasty techniques: commissural annuloplasty (n=124), complete ring annuloplasty (n=113), and an unmeasured, posterior, partial ring annuloplasty (n=181). Intraoperatively, before repair, severity of mitral regurgitation as measured by double sampling dye curves and transesophageal echocardiography was similar in all three groups; after mitral valve repair, intraoperative assessment showed a similar degree of reduction in regurgitation in the three annuloplasty groups. Before hospital dismissal, transthoracic echocardiography demonstrated that tire mean mitral valve areas and gradients were similar in the three groups; more patients having commissural annuloplasty were classified as having grade II or greater regurgitation. Mortality (n=7, 1.7%) and need for reoperation (n=8, 1.9%) was low in all groups despite the fact thai additional procedures were per formed in 48.8% of patients. Durations of cardiopulmonary bypass and aortic cross- clamping were significantly less in patients having commissural or posterior annuloplastics compared with those receiving a complete ring annuloplasty. Conclusions: These early results indicate that the posterior annuloplasty method is reproducible and expeditious. Postoperative valve function as assessed by degree of regurgitation, transvalvular gradient, and valve area was similar to thai obtained by measured, complete ring annuloplasty and superior to that found in patients having commissural annuloplasty.

AB - Background: We hypothesized that a simple, unmeasured posterior annuloplasty technique (two thirds of a 27-mm Duran ring) offered advantages of standardization and ease of insertion. Methods and Results: A consecutive series of all patients (n=418; median age, 67 years) having mitral valve repair performed by two surgeons was analyzed to determine the outcome of three different annuloplasty techniques: commissural annuloplasty (n=124), complete ring annuloplasty (n=113), and an unmeasured, posterior, partial ring annuloplasty (n=181). Intraoperatively, before repair, severity of mitral regurgitation as measured by double sampling dye curves and transesophageal echocardiography was similar in all three groups; after mitral valve repair, intraoperative assessment showed a similar degree of reduction in regurgitation in the three annuloplasty groups. Before hospital dismissal, transthoracic echocardiography demonstrated that tire mean mitral valve areas and gradients were similar in the three groups; more patients having commissural annuloplasty were classified as having grade II or greater regurgitation. Mortality (n=7, 1.7%) and need for reoperation (n=8, 1.9%) was low in all groups despite the fact thai additional procedures were per formed in 48.8% of patients. Durations of cardiopulmonary bypass and aortic cross- clamping were significantly less in patients having commissural or posterior annuloplastics compared with those receiving a complete ring annuloplasty. Conclusions: These early results indicate that the posterior annuloplasty method is reproducible and expeditious. Postoperative valve function as assessed by degree of regurgitation, transvalvular gradient, and valve area was similar to thai obtained by measured, complete ring annuloplasty and superior to that found in patients having commissural annuloplasty.

KW - mitral valve

KW - surgery

KW - valvuloplasty

UR - http://www.scopus.com/inward/record.url?scp=0028791357&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028791357&partnerID=8YFLogxK

M3 - Article

C2 - 7586400

AN - SCOPUS:0028791357

VL - 92

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 9 SUPPL.

ER -