Mitral valve (MV) repair: Widely regarded as the procedure of choice for significant degenerative mitral regurgitation (MR) requiring surgery1
Late recurrence of valvular dysfunction: Great risk in rheumatic heart disease,
mixed mitral stenosis (MS) and MR
In non-rheumatic disease: Recurrent MR (m/c cause of failure)
MS (rare):Pannus overgrowth from the annuloplasty ring (Fig.
→ Small mitral annuloplasty rings,
Type of ring annuloplasty (Flexible (Duran) ring > rigid (Carpentier-Edwards) ring)2-4
This study investigated computed tomographic (CT) appearance aftermitral ring annuloplasty,
Methods and Materials
◦ Retrospective review of medical records and cardiac CT scan
- Patients who underwent MV annuloplasty from Jan 1995 to Dec 2013
- Patients who underwent cardiac CT from Mar 2008 to Aug 2014
-Patient with interval less than 1 year between CT and MV annuloplasty (n=13)
- Patients with rheumatic heart disease (n=6)
- Patients with no ring or other ring types (n=3)
- Patients with non-assessable CT image quality (n=2)
◦ A total of...
1.Patient characteristics (Fig.
◦ Ring type : 27 CE ring vs.
18 Duran ring
◦ Significant difference in mean time after MV annuloplasty between ring types (P<0.05)
CT Analysis of Annuloplasty Rings
◦ Pannus around the annuloplasty ring : 29 of 45 cases (64.4%)
◦ Significant pannus: 10 patients (22.2%)
◦ Leaflet thickening (>2mm): 31 of 45 patients (68.9%)
◦ Valve opening area : 2.34 ± 0.717 cm2 (n=22)
◦ Patients with significant pannus vs.
patients with no or insignificant
- Significant difference...
Significant pannus around the annuloplastyring on CT may cause functional MS after mitral ring annuloplasty.
This may occur more frequently for the Duranring.
Cardiac CT can be helpful in patients with Duran ringannuloplasty who show elevated PG by further evaluatingthe cause of their PG elevation.
Factors affecting mitral valve reoperation in 317 survivors after mitral valve reconstruction.
The Annals of thoracic surgery.
Sep 1992;54(3):440-447; discussion 448.
Mitral stenosis after mitral valve repair for non-rheumatic mitral regurgitation.
Ann Thorac Surg. 2002;73:34-6.
Long-term outcomes after mitral ring annuloplasty for degenerative mitral regurgitation: Duran ring versus Carpentier-Edwards ring.
J Heart Valve Dis. 2007;16:536-44; discussion 44-5.