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Published in: Journal of Cardiothoracic Surgery 1/2017

Open Access 01-12-2017 | Research article

Mid-term results of mitral valve repair using flexible bands versus complete rings in patients with degenerative mitral valve disease: a prospective, randomized study

Authors: Alexandr V. Bogachev-Prokophiev, Alexandr V. Afanasyev, Sergei I. Zheleznev, Vladimir M. Nazarov, Ravil M. Sharifulin, Alexandr M. Karaskov

Published in: Journal of Cardiothoracic Surgery | Issue 1/2017

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Abstract

Background

We aimed to compare the outcomes of mitral valve repair with flexible band (FB) versus complete semirigid ring (SR) in degenerative mitral valve disease patients.

Methods

From September 2011 to 2014, 171 patients were randomized and underwent successful mitral valve repair using a SR (n = 85) or FB (n = 86). There were no significant between-group differences at baseline.

Results

There were no early mortalities. The mean follow up was 24.7 months. The 2-year survival was 96.0 ± 2.3% (95% confidence interval [CI], 88.6–98.7%) and 94.3 ± 2.8% (95% CI, 85.5–97.9%) in the SR and FB groups, respectively (p = 0.899). The left ventricle remodeling was similar between the groups. Higher transmitral peak (8.5 [3.9–17] vs. 6 [2.1–18] mmHg, p < 0.001), mean pressure gradients (3.7 [1.3–8] vs. 2.8 [0.6–6.8] mmHg, p = 0.001), and systolic pulmonary artery pressure (34.5 [20–68] vs. 29.5 [8–48] mmHg, p < 0.001) was observed in the SR group. The 2-year freedom from recurrence of significant mitral regurgitation was significantly higher in the FB group than the SR group (p = 0.002). Residual mitral regurgitation was an independent prognostic factor of recurrence of mitral regurgitation. The 3-year freedom from reoperation was significantly higher in the FB group than the SR group (p = 0.044).

Conclusion

Patients with degenerative mitral valve disease may benefit from valve repair with FBs. Residual mitral regurgitation before discharge is an independent risk factor of late insufficiency recurrence.

Trial registration

ClinicalTrials.gov NCT03278574, retrospectively registered on 06.09.2017.
Appendix
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Metadata
Title
Mid-term results of mitral valve repair using flexible bands versus complete rings in patients with degenerative mitral valve disease: a prospective, randomized study
Authors
Alexandr V. Bogachev-Prokophiev
Alexandr V. Afanasyev
Sergei I. Zheleznev
Vladimir M. Nazarov
Ravil M. Sharifulin
Alexandr M. Karaskov
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2017
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-017-0679-0

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