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

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

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.

Keywords: Degenerative mitral valve disease; Mitral regurgitation; Mitral valve repair.

Conflict of interest statement

Ethics approval and consent to participate

Study was approved by local Ethical Committee at Aughust 1, 2011, approval number PA – 112.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Consort flow diagram
Fig. 2
Fig. 2
Kaplan-Meier survival estimates. Abbreviation: SR – semirigid ring; CI, confidence interval
Fig. 3
Fig. 3
a. Kaplan-Meier freedom from moderate and severe mitral regurgitation. b. Kaplan-Meier freedom from severe mitral regurgitation. Abbreviation: MR, mitral regurgitation; SR – semirigid ring; CI, confidence interval
Fig. 4
Fig. 4
Kaplan-Meier freedom from reoperations. Abbreviation: SR – semirigid ring; CI, confidence interval

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