Preliminary experience in mitral valve repair using theCosgrove?Edwards annuloplasty ring

Abstract

There is a wide range of annuloplasty systems available now. However, controversy concerning the choice of annuloplasty device persists. We analyzed our preliminary experience in mitral valve repair using the Cosgrove-Edwards annuloplasty ring. To correct their mitral insufficiency (MI), 118 consecutive patients (mean age, 60.4+/-15.1 years) underwent mitral repair using this annuloplasty device. NYHA functional class 3 or 4 were present in 86.4%. Degenerative heart disease was the cause of MI in 36.6% of the patients, ischemic heart disease in 25.4%, Barlow's disease in 17.8%, and idiopathic dilated cardiomyopathy in 7.6%. Mitral surgical procedures included quadrangular resection and sliding of the posterior leaflet, posterior leaflet decalcification, anterior leaflet repair, the edge-to-edge technique, and chordal repair. Mean follow-up was 25.1+/-14.0 months. There were four in-hospital non-valve-related cardiac deaths, and one in-hospital non-cardiac death. No cases of systolic anterior motion were observed. NYHA functional class improved from 3.3+/-0.7, before repair, to 1.3+/-0.6, at follow-up (P=0.00012), MI from 3.6+/-0.5 to 0.5+/-0.6 (P=0.0096), and left ventricular ejection fraction from 52.0+/-12.2% to 55.4+/-12.0% (P=0.044). Three-year actuarial rates of survival, freedom from thromboembolism, and freedom from mitral reoperation were 96.9, 97.9, and 96.4%, respectively. The Cosgrove-Edwards annuloplasty ring does not combine with systolic anterior motion. It minimizes MI secondary to all causes, and preserves left ventricular function.