Abstract
Background
We assessed the mitral annular motion after mitral valve repair with the Sorin Memo 3D® (Sorin Group Italia S.r.L., Saluggia, Italy), which is a unique complete semirigid annuloplasty ring intended to restore the systolic profile of the mitral annulus while adapting to the physiologic dynamism of the annulus, using transesophageal real-time three-dimensional echocardiography.
Methods
17 patients (12 male; mean age 60.4 ± 14.9 years) who underwent mitral annuloplasty using the Memo 3D ring were investigated. Mitral annular motion was assessed using QLAB®version8 allowing for a full evaluation of the mitral annulus dynamics. The mitral annular dimensions were measured throughout the cardiac cycle using 4D MV assessment2® while saddle shape was assessed through sequential measurements by RealView®.
Results
Saddle shape configuration of the mitral annulus and posterior and anterior leaflet motion could be observed during systole and diastole. The mitral annular area changed during the cardiac cycle by 5.7 ± 1.8%.The circumference length and diameter also changed throughout the cardiac cycle. The annular height was significantly higher in mid-systole than in mid-diastole (p < 0.05).
Conclusions
The Memo 3D ring maintained a physiological saddle-shape configuration throughout the cardiac cycle. Real-time three-dimensional echocardiography analysis confirmed the motion and flexibility of the Memo 3D ring upon implantation.
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References
American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Society of Cardiovascular Anesthesiologists; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons. Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 2006;114:e84–e231.
Nardi P, Pellegrino A, Olevano C, Scafuri A, Lio A, Polisca P, et al. Mitral valve repair for the treatment of degenerative mitral valve disease with or without prosthetic ring annuloplasty: long-term outcomes. J Cardiovasc Surg (Torino) 2013;54:305–12.
Hu X, Zhao Q. Systematic evaluation of the flexible and rigid annuloplasty ring after mitral valve repair for mitral regurgitation. Eur J Cardiothorac Surg. 2011;40:480–7.
Bruno PG, Leva C, Santambrogio L, Lazzarini I, Musazzi G, Del Rosso G, et al. Early clinical experience and echocardiographic results with a new semirigid mitral annuloplasty ring: the Sorin Memo 3D. Ann Thorac Surg. 2009;88:1492–8.
Sugeng L, Coon P, Weinert L, Jolly N, Lammertin G, Bednarz JE, et al. Use of real-time 3-dimensional transthoracic echocardiography in the evalu ation of mitral valve disease. J Am Soc Echocardiogr. 2006;19:413 – 21.
Dall’Agata A, Taams MA, Fioretti PM, Roelandt JR, Van Herwerden LA. Cosgrove-Edwards mitral ring dynamics measured with transesophageal three-dimensional echocardiography. Ann Thorac Surg. 1998;65:485–90.
Borghetti V, Campana M, Scotti C, Domenighini D, Totaro P, Coletti G, et al. Biological versus prosthetic ring in mitral-valve repair: enhancement of mitral annulus dynamics and left-vent, ricular function with pericardial annuloplasty at long-term. Eur J Cardiothorac Surg. 2000;17:431–9.
Chee T, Haston R, Togo A, Domenighini D, Totaro P, Coletti G, et al. Is a flexible mitral annuloplasty ring superior to semi-rigid or rigid ring in terms of improvement in symptoms and survival? Interact Cardiovasc Thorac Surg. 2008;7:477–84.
Jimenez JH, Liou SW, Padala M, He Z, Sacks M, Gorman RC, et al. A saddle-shaped annulus reduces systolic strain on the central region of the mitral valve anterior leaflet. J Thorac Cardiovasc Surg. 2007;134:1562–8.
Santarpino G, Pfeiffer S, Fischlein T. First-in-man implantation of a Sorin Memo 3D ring: mitral annular flexibility is still preserved at 5 years of follow-up! Int J Cardiol. 2012;23;159:e23–e4.
Topilsky Y, Vaturi O, Watanabe N, Bichara V, Nkomo VT, Michelena H, et al. Real-time 3-dimensional dynamics of functional mitral regurgitation: a prospective quantitative and mechanistic study. J Am Heart Assoc. 2013;2:e000039.
Vergnat M, Levack MM, Jassar AS, Jackson BM, Acker MA, Woo YJ, et al. The influence of saddle-shaped annuloplasty on leaflet curvature in patients with ischaemic mitral regurgitation. Eur J Cardiothorac Surg. 2012;42:493–9.
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Nishi, H., Toda, K., Miyagawa, S. et al. Annular dynamics of memo3D annuloplasty ring evaluated by 3D transesophageal echocardiography. Gen Thorac Cardiovasc Surg 66, 214–219 (2018). https://doi.org/10.1007/s11748-018-0886-1
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DOI: https://doi.org/10.1007/s11748-018-0886-1