Document Detail


Long-term outcomes after mitral ring annuloplasty for degenerative mitral regurgitation: Duran ring versus Carpentier-Edwards ring.
MedLine Citation:
PMID:  17944126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: The preferred choice of annuloplasty ring in mitral surgery has not yet been determined. The study aim was to compare the effects of using two ring types, the Duran and the Carpentier-Edwards, for degenerative mitral valve repair. METHODS: The follow up data were reviewed from 294 patients who underwent mitral valvuloplasty for degenerative mitral regurgitation (MR) with either a Carpentier-Edwards ring (n = 153) or a Duran ring (n = 141), between 1994 and 2004. The long-term clinical and echocardiographic outcomes were compared. RESULTS: There were no inter-group preoperative demographic differences. The preoperative left ventricular (LV) ejection fraction (EF) and MR grade were similar in both groups, but the left atrial (LA) size, LV mass and LV dimension were significantly greater in the CE group. Rates of overall survival, reoperation-free survival and MR (> or = 3)-free survival were similar in the two groups (five-year MR-free survival 75.1 +/- 4.6% for CE and 82.4 +/- 4.5% for Duran; p = 0.83). The CE group showed an overall superior five-year mitral stenosis (MS)-free survival. Significantly more Duran patients had a mean transmitral pressure gradient (MPG) of > or = 10 mmHg (five-year MS (MPG > or = 10 mmHg)-free survival rate: 91.2 +/- 2.8% in for CE and 65.1 +/- 10.7% for Duran group; p = 0.011). The LV EF did not change over time in either group. In contrast, the LV mass and LV dimension decreased significantly after surgery in both groups, but no significant inter-group difference was seen for either index. CONCLUSION: Although the Duran and Carpentier-Edwards rings showed comparable long-term outcomes in terms of LV function, MR recurrence, survival and reoperation, a greater tendency towards MS development was observed with the Duran ring, this being most likely due to late pannus formation.
Authors:
Cheol Hyun Chung; Joon Bum Kim; Suk Jung Choo; Kyung Sun Kim; Hyun Song; Meong Gun Song; Jae-Kwan Song; Duk-Hyun Kang; Jae Won Lee
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  16     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-10-19     Completed Date:  2008-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  536-44; discussion 544-5     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiovascular Surgical Procedures / instrumentation*,  methods*
Female
Follow-Up Studies
Heart Valve Prosthesis*
Humans
Longitudinal Studies
Male
Middle Aged
Mitral Valve / physiopathology,  surgery*
Mitral Valve Insufficiency / physiopathology,  surgery*
Recurrence
Retrospective Studies
Stroke Volume / physiology
Survival Analysis
Treatment Outcome
Ventricular Function, Left / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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