Summary
This observational analysis from two cardiothoracic surgical trials examined 214 patients with ischaemic mitral regurgitation who underwent restrictive ring annuloplasty. The study found that the ratio of left ventricular end-systolic dimension to ring size was significantly associated with recurrent mitral regurgitation at 1 year post-repair, independent of age, sex, baseline ejection fraction and baseline regurgitation severity. The findings suggest that consideration of left ventricular size relative to ring size may improve surgical outcomes and guide decisions about ring selection or the need for additional interventions.
UK applicability
As a cardiac surgical outcomes study from United States trials, the findings are directly applicable to UK cardiac surgical practice, though implementation would require integration into UK National Institute for Health and Care Excellence guidance and individual NHS trust protocols for mitral valve repair.
Key measures
Left ventricular end-diastolic dimension, left ventricular end-systolic dimension (LVESd), ring size, LV-MV ring mismatch ratio (LV dimension/ring size), moderate or greater mitral regurgitation recurrence at 1 year
Outcomes reported
The study measured the association between left ventricular to mitral valve ring size mismatch and recurrence of moderate or greater mitral regurgitation at 1 year post-surgery in patients undergoing ring annuloplasty for ischaemic mitral regurgitation. At 1 year, 21% of patients (45/214) developed recurrent moderate or greater mitral regurgitation.
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