• Wenrui Ma, Wei Ye, Jing Zhang, Wei Zhang, Weihua Wu, and Ye Kong.
• Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 Huaihaixi Rd, Shanghai, 200030, China.
• Int J Cardiovasc Imaging. 2018 Nov 1; 34 (11): 1707-1713.

AbstractWe sought to investigate the impact of full annuloplasty rings versus C-shape bands on mitral annular geometry in the presence of fibroelastic deficiency (FED), as assessed by intraoperative three-dimensional transesophageal echocardiography (3DTEE). We retrospectively selected 65 patients who underwent mitral valve repair for severe mitral regurgitation caused by FED using full rings (the Ring group, n = 30) and C-shape bands (the Band group, n = 35). 71 controls without valvular heart disease were also included. Thorough 3DTEE inspections were performed for the entire cohort to measure morphological parameters of mitral annulus before and after surgery. Mid-term repair durability and left atrial diameter were followed up. The preoperative 3DTEE parameters, including annular diameters, area, height and aorto-mitral angle, were significantly larger in the FED groups than normal, and were comparable between two groups using different annuloplasty devices. After repair, the anterior-posterior diameter, annulus circumference and area were significantly larger in the Band group than in the Ring group. The aorto-mitral angle became comparable with normal value in the Ring group (p = 0.728), but not in the Band group (p = 0.011). Follow-up echocardiographic data showed a significant correlation between postoperative aorto-mitral angle and reduced left atrial diameter at 50.3 months after surgery (r = 0.63; p < 0.001). In conclusion, compared with C-shape bands, full rings may impose less narrowing on aorto-mitral angle, which correlates well with mid-term left atrial reverse remodeling.

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