The “Physio-Ring”: an advanced concept in mitral valve annuloplasty

Mitral valve repair with a malleable bovine pericardium ring

“…This permitted the achievement of a better result, 65% of the patients passing to functional class I with recovery of left ventricular geometry and mechanical function of the mitral valve, as is also reported in the literature 26,28,34,35 . A follow-up period of 16 months showed a survival ratio of 93.8%; other studies, with lower 29 or equal 36 follow-up periods, reported 98% indexes. Studies with follow-up periods of five 26,28 , eight 35 and 16 34 years, reported survival rates of respectively, 90 to 98.8±1.2%, 88±4%, and 76.1±-3.1%.…”

Mitral Valve Anatomic Predictors of Hemodynamic Success With Transcatheter Mitral Valve Repair

“…blinded to the procedural result and LAP measurements. Specific mitral valve anatomic characteristics included the following: presence/absence of flail leaflet, flail width >15 mm, flail gap >10 mm, location of the dominant mitral regurgitant jet (A2/P2 versus other location as assessed by Carpentier's classification), the presence and location of any secondary regurgitant jets, posterior mitral leaflet grasping length, presence/absence of mitral annular calcification, presence/absence of leaflet calcification, commissural prolapse involving the dominant regurgitant jet,12 maximum width of the dominant regurgitant jet (vena contracta), baseline mitral valve mean diastolic gradient, postprocedure mitral mean diastolic gradient, the presence/absence of posterior mitral leaflet cleftlike indentations, and the presence of redundant mitral leaflets with extensive prolapse involving ≥50% of mitral leaflet tissue. MR severity was graded using an integrated multiparametric approach in accordance with current American Society of Echocardiography guidelines 13.…”

Resultados alejados de la cirugía reparadora de la insuficiencia mitral isquémica

“…Inicialmente utilizamos el anillo de Carpentier-Edwards Classic, que persigue la remodelación bidimensional del anillo mitral, llevándolo a su forma original, la que no es un círculo, sino que se asemeja a un riñón, para luego utilizar el anillo Physio-Ring, que introduce ahora una remodelación tridimensional devolviendo al anillo mitral su forma en "silla de montar", además de tener una cierta fl exibilidad 26,27 . Finalmente, adoptamos el anillo de Carpentier-McCarthy-Adams, especialmente diseñado para la insufi ciencia mitral isquémica ventricular, que incorpora ya una sobre-reducción del diámetro ántero-posterior y una tracción hacia el plano auricular de la porción póstero-medial del anillo mitral, que es la que experimenta mayor tracción hacia apical en el infarto inferior, principal causa de una insufi ciencia mitral isquémica ventricular 28 .…”