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DOI: 10.1055/s-0029-1191602
Annuloplasty in functional mitral regurgitation and concomitant coronary heart disease: Comparison CE IMR ETlogix/CE physio ring
Objective: The aim of the study was to analyse different annuloplasty rings in patients with functional mitral regurgitation (MR) and coronary heart disease regarding the clinical and functional outcome.
Methods: 197 patient received annuloplasty because of functional MR between 2002 and 2006. 79 patients with concomitant bypass-grafting were retrospectively analyzed. IMR ETlogix-ring was implanted in 28 (25% female) patients (group I), Physio-ring in 51 (40% female) patients (group II).
Results: Both groups were comparable in mean age (65±12 vs. 67±9 years), EuroSCORE (7.8±3 vs. 9.1±9), NYHA-class (2.9±0.7 vs. 2.6±0.7), (group I vs. group II respectively, p=n.s.). Significant different were number of patients with ejection fraction (EF) <30% (22% vs. 41%, p<0.05) and myocardial infarction (81% vs. 65%, p<0.05). Mean OR time was significantly different (321±115 vs, 374±87min, p<0.005), whereas ECC- (190±69 vs. 193±47min), cross-clamp-time (120±37vs. 121±27min), additional bypass-grafting (2.3±0.8 vs. 2.6±0.9), ICU- (5.7±4.7 vs. 6.2±4.9days) and hospital-stay (13±11 vs. 10±9.4days) were comparable (group I vs. group II respectively, p=n.s.). Hospital mortality was 7.1% group I vs. 7.8 group II (p=n.s.). Echocardiography at discharge revealed non/mild MR in 96% and 94% with mean gradient of 4.4±2.0mmHg vs. 4.75±2.7mmHg (group I vs. group II respectively, p=n.s.). Only 20% of patients with EF<30% showed an improvement of left ventricular function in both groups (p=n.s.).
Conclusion: Mitral valve repair demonstrated good functional results in all patients, but there was no improvement in terms of NYHA-class and EF early postoperatively. The implanted ring and its geometry did not seem to have a major impact.