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J Thorac Cardiovasc Surg 1995;110:1333-1337
© 1995 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

ATRIOVENTRICULAR VALVE REPAIR USING EXTERNALLY ADJUSTABLE FLEXIBLE RINGS

J. Q. Melo, MD, PhD (by invitation), M. Abecasis, MD (by invitation), J. Neves, MD (by invitation), L. Bruges, MD (by invitation), M. Ferreira, MD (by invitation), M. J. Rebocho, MD (by invitation), R. Ribeiras, MD (by invitation), M. Canada, MD (by invitation), R. Seabra-Gomes, MD, PhD (by invitation), Manuel Machado-Macedo, MD, PhD


Carnaxide, Portugal

From the Departments of Cardiothoracic Surgery and Cardiology of the Hospital de Santa Cruz and the Instituto do Coração, Carnaxide, Portugal.

Address for reprints: Joao Q. Melo, Servico de Cirurgia Cardiotoracica, Hospital de Santa Cruz, Avenida Professor Reynaldo dos Santos, Carnaxide 2795 Linda-A-Velha, Portugal.

Abstract

Initial results obtained with a new flexible ring, adjustable from outside of the heart after interruption of extracorporeal circulation, are presented. Twenty-five rings have been inserted in 20 patients, 14 in the mitral position and 11 in the tricuspid position. In 8 of the 14 patients receiving mitral annuloplasty, other standard mitral valve repair techniques were used. Adjustment, assisted by intraoperative transesophageal color Doppler echocardiography, was done for 10 (71%) of the mitral rings and for 8 (73%) of the tricuspid rings. Residual mitral regurgitation disappeared or became minimal in 9 (90%) patients, and a mild regurgitation remained in 1. In all patients who received tricuspid rings regurgitation was abolished after the adjustment. There was no hospital or late mortality. After a maximum follow-up of 6 months results are comparable in the tricuspid and mitral positions and echocardiographic evaluation revealed stable competent valves in all patients but one, who underwent reoperation because of failure of a mitral valve chordae shortening procedure. The use of externally adjustable rings for the mitral and tricuspid valves is a safe alternative for atrioventricular valve annuloplasty and has the additional advantage of reducing postrepair regurgitation. (J THORAC CARDIOVASC SURG 1995;110:1333-7)






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