Improvement of mitral valve coaptation with supraannular plication of the posterior annulus -A newly designed strip for Posterior Annular Plication-

摘要

Purpose: The aim of this study was to evaluate a newly-designed mitral annuloplasty strip (the Mitra-Lift? strip) in patients undergoing mitral valve repair for mitral regurgitation (MR). Methods: A total of 30 patients who underwent posterior mitral strip annuloplasty for moderately severe to severe MR were evaluated in this study. The strip annuloplasty (SA) consisted of the use of the newly-designed strip and the suture of the supra-annular atrial wall of 5.0 mm width and the posterior annulus. In addition to SA, six patients (20.0%) with tethered posterior leaflets required posterior leaflet augmentation. Improvement in MR and hemodynamic parameters of the valve with the fixed strip were assessed. Results: After SA, all patients exhibited little or no MR, with no individual exhibiting signs of exacerbation during the follow-up period. A stable coaptation occurred below the strip and the posterior annulus due to forward movement and lifting of the posterior annulus without significant reduction of intercommissural dimension. During the cardiac cycle, the intercommissural dimensions showed considerable changes, which meant a dynamic motion of the anterior leaflet and the commissures. Conclusions: Formation of a stable leaflet coaptation was associated with a dynamic change of the intercommissural dimension during the cardiac cycle and resulted in a reliable, annuloplasty strip, representing a new concept in annuloplasty.