Long-term Outcomes of Semirigid Ring and Band Annuloplasty in Functional Mitral Regurgitation Patients without Advanced Left Ventricular Dilation.

Document Type

Article

Publication Date

6-26-2025

Publication Title

The Journal of thoracic and cardiovascular surgery

Abstract

OBJECTIVE: Our study aims to compare long-term survival and clinical outcomes of ring and band prostheses for annuloplasty repair of functional mitral regurgitation (FMR).

METHODS: From 3/2005 to 11/2017, 160 patients with moderate to severe FMR underwent undersized annuloplasty using semirigid complete ring (CR, N=69) or partial band (PB, N=91) prostheses of the same material and manufacturer. Primary outcomes were long-term survival and clinical outcomes, while secondary outcomes included comparison of postoperative echocardiography data.

RESULTS: Both groups had comparable baseline characteristics, cardiac function, FMR severity, and perioperative complications. CR and PB experienced equivalent 10-year freedom from CV mortality(65.2% vs 68.3%, P=.39), and FMR recurrence (78.5% vs 71.4%, P=.27).At mean follow-up of 58±46 months, both groups had parallel increase in ejection fraction (+7±16 vs +5±15%, P=.35) and reduction of left ventricle internal diameter end-diastole (-0.5±0.8 vs -0.4±0.9 cm, P=.61). CR had greater reduction in left ventricle internal diameter end-systole (-0.6±0.9 vs -0.2±0.9 cm, P=.007) but higher mean (5.6±3.4 vs 5.0±7 mmHg, P=.025) and peak (16.7±19.4 vs 12.9±10.7 mmHg, P=.048) transvalvular pressure gradients (TPG). Mean TPG predicted postoperative mortality at 10-years (HR 1.19[CI 95% (1.0037-1.357)], P=.013).

CONCLUSION: CR and PB annuloplasty for FMR confer equivalent 10-year survival and MR recurrence. CR repair was associated with increased LV reverse remodeling yet higher long-term valvular gradients.

Volume

S0022-5223

Issue

25

First Page

00543-4

DOI

10.1016/j.jtcvs.2025.06.023

ISSN

1097-685X

PubMed ID

40581290

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