Annuloplasty of the posterior leaflet bend and restrictive mitral annuloplasty with a support ring: comparative of results

• Bazylev V.V.
• Tungusov D.S.
• Senzhapov I.Ya.
• Urunov A.O.
• Denisov M.A.
• Mikulyak A.I.

Abstract

Aim is to evaluate the long-term results of surgical treatment using modified plastic surgery according to A. Calafiore and mitral annuloplasty with a support ring in patients with ischemic mitral regurgitation.

Material and methods. This retrospective single-center study included 401 patients with coronary heart disease and ischemic mitral regurgitation. Depending on the tactics of surgical treatment, patients were divided into 2 groups: group 1 – 156 patients who underwent coronary artery bypass grafting and annuloplasty of the posterior leaflet with a PTFE band (modified A. Calafiore plastic); group 2 – 245 patients who underwent coronary artery bypass grafting and restrictive mitral annuloplasty with a semi-rigid closed support ring.

Results. Support ring implantation time is longer than PTFE band mitral valve repair, as evidenced by myocardial ischemia time and operative time. In the long-term period, 8 (5.1%) people died from progression of heart failure in the group of patients who underwent plastic surgery according to A. Calafiore and 10 (6%) people who underwent plastic surgery with a support ring. In the long-term period, recurrence of moderate and severe mitral regurgitation was detected in 6 people in the group 1, and in 19 people – in the group 2.

Conclusion. Modified plastic surgery according to A. Calafiore reduces myocardial ischemia time and operation time. The survival and health of the mitral valve with restrictive mitral annuloplasty with a support ring is higher than with modified repair according to A. Calafiore.

Keywords: mitral valve; mitral valve repair; mitral valve support ring

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