37. THE COSGROVE-EDWARDS ANNULOPLASTY SYSTEM PRESERVES MITRAL ANNULAR FLEXIBILITY AND FUNCTION AT 5 YEARS
A. Marc Gillinov, Delos M. Cosgrove, Takahiro Shiota, James D. Thomas, Eugene H. Blackstone
The Cleveland Clinic Foundation
Cleveland, Ohio, USA
OBJECTIVE
The purpose of this study was to evaluate midterm clinical and functional results of mitral valve repair using a flexible annuloplasty band.
MATERIAL AND METHODS
From February 1993 to July 1994, 197 consecutive patients (pts) had mitral valve repair using the Cosgrove-Edwards Annuloplasty System. Valve disease was degenerative in 73%, rheumatic in 15%, ischemic in 5%, and other in 7%.
RESULTS
After repair, echocardiographic mitral regurgitation (MR) was none in 92%, 1+ in 5%, and 2+ in 3%. Late follow-up was available in 195 pts (99%). Four-year actuarial survival was 93%, freedom from thromboembolism 94%, from endocarditis 98%, and from reoperation 95%. Late echocardiography in 157 pts demonstrated no MR in 56%, 1+ in 24%, 2+ in 9%, 3+ in 6%, and 4+ in 3%. At a mean of 61 months after repair, 3D echocardiograms in 10 patients were obtained and compared to those from 8 normal volunteers (Table).
|
|
Annular Circumference (cm) Diastole Systole |
Annular Area (cm2) Diastole Systole |
|
Patient |
12 ± 3 10 ± 2* |
10 ± 4 7 ± 3* |
|
Control |
12 ± 2 11 ± 1* |
11 ± 3 9 ± 2* |
*P<0.05 vs diastolic value
The normal saddle shape and sphincter action of the mitral annulus were demonstrated in both patients and controls, with similar reductions in mitral annular circumference and area during the cardiac cycle in both groups.
CONCLUSION
This annuloplasty system is effective for repair of MR secondary to all causes and preserves mitral annular flexibility and function at 5 years follow-up.
