Flexible posterior mitral annuloplasty: five-year clinical and Doppler echocardiographic results

Mitral valve repair with a malleable bovine pericardium ring

“…This observation led to the proposal of an exclusively posterior prosthesis annuloplasty 26 or of a merely continuous suture, similar to a "De Vega" 25 . Evolution confirmed the superiority of rings for posterior conformation [26][27][28][29][30] .…”

“…Acquired experience, understanding of the role of the mitral valve apparatus in left ventricular function, and decreased postoperative morbidity and mortality led to the expansion of the number of valve repair interventions 30,38 known 39 to lead to a better postoperative performance of the left ventricle as well. Long-term results showed ventricular function restored to normal levels, significantly improved survival ratios in particular following solely mitral procedures 34 , which in the present work were performed in 71.8% of the patients.…”

“…During later evolution, this patient required mitral valve replacement, which however, led to death. The literature shows a reoperation-free ratio of patients who undergo valve repair, fluctuating between 49 and 100% during a follow-up period of 4 to 17 years 26,30,33,43,44 . The lower ratio was not always related to a longer follow-up period.…”

“…Analysis of mitral valve repir reveals the importance of annulus remodeling using some type of prosthesis, bearing in mind that the absence of annuloplasty is associated with a higher incidence of precocious failure 30 . A study by Bernal et al 34 , utilizing a complete, malleable ring, revealed that 89.9±3.2% of their rheumatic patients remained free of reoperation over a 16-year period.…”

“…Valve repair techniques using rings are based on the anterior leaflet area, associated or not with intertrigonal or intercommissural distances for the selection of annular prosthesis size 10,13,[27][28][29][30] . In 1985, Braile et al 26 developed specific measuring devices aimed at the evaluation of the anterior cusp perimeter, thus introducing a new concept for the choice of annular prosthesis size.…”