Pulse Brain · Growing Health Evidence Index
Tier 2 — RCT / large cohortPeer-reviewed

Impact of Left Ventricular to Mitral Valve Ring Mismatch on Recurrent Ischemic Mitral Regurgitation After Ring Annuloplasty

Romain Capoulade, Xin Zeng, Jessica Overbey, Gorav Ailawadi, John H. Alexander, Deborah D. Ascheim, Michael E. Bowdish, Annetine C. Gelijns, Paul Grayburn, Irving L. Kron, Robert A. Levine, Michael J. Mack, Serguei Melnitchouk, Robert E. Michler, John C. Mullen, Patrick T. O’Gara, Michael K. Parides, Peter K. Smith, Pierre Voisine, Judy Hung

Circulation · 2016

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Summary

This analysis of 214 patients from two cardiothoracic surgical trials examined whether mismatch between left ventricular size and mitral valve ring size predicts recurrent mitral regurgitation after restrictive ring annuloplasty. The study found that larger left ventricular end-systolic dimension relative to ring size independently predicted one-year mitral regurgitation recurrence, even after adjustment for baseline ejection fraction and regurgitation severity. The findings suggest that consideration of ventricular-to-ring sizing ratios, rather than ring size alone based on intertrigonal distance, may improve surgical outcomes and guide selection of repair versus replacement strategies.

UK applicability

The findings are relevant to cardiac surgery practice in the United Kingdom, as they provide evidence-based guidance for selecting appropriately sized annuloplasty rings in ischaemic mitral regurgitation repair. However, applicability depends on whether UK surgical cohorts and imaging protocols are comparable to those in the enrolled trials.

Key measures

Left ventricular end-diastolic dimension, left ventricular end-systolic dimension, ring size, LV-MV ring mismatch ratio (LVESd/ring size), recurrent moderate or greater mitral regurgitation at 1 year

Outcomes reported

The study measured the rate of recurrent moderate or severe mitral regurgitation at one year following ring annuloplasty in patients with ischaemic mitral regurgitation, and evaluated the association between left ventricular to mitral valve ring size mismatch and recurrence.

Theme
General food systems / other
Subject
Other / interdisciplinary
Study type
Research
Study design
Observational cohort analysis from two multicentre randomised controlled trials
Source type
Peer-reviewed study
Status
Published
System type
Human clinical
DOI
10.1161/circulationaha.115.021014
Catalogue ID
BFmokjo9ap-8wfvhi

Topic tags

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