Al-Maisary Sameer, Graser Bastian, Engelhardt Sandy, Wolf Ivo, Karck Matthias, DE Simone Raffaele
Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany -
German Cancer Research Center, Heidelberg, Germany.
J Cardiovasc Surg (Torino). 2017 Jun;58(3):481-488. doi: 10.23736/S0021-9509.16.09314-9. Epub 2016 May 6.
Different types of mitral annuloplasty rings are commercially available. The aim of this study was to investigate the effect of implantation of six types of annuloplasty rings on the geometry and dynamics of the mitral valve.
Three-dimensional echocardiography images of 42 patients were acquired to visualize the mitral valve annulus. Virtual representations of six commercially available annuloplasty rings were matched to anatomical mitral annuli of each patient according to anterolateral-posteromedial diameter. The virtual displacement of each annuloplasty ring after the implantation was measured and compared with the other rings.
Patients with severe mitral regurgitation had significantly dilated annuli according to anterolateral-posteromedial diameter, anterior-posterior diameter and to annulus circumference. Anterior and posterior heights of the mitral annuli and non-planarity angle showed no significant differences among different patients with different degree of mitral regurgitation. The ratio of anterior-posterior to anterolateral-posteromedial diameter was almost identical in all groups with identical annular shapes. The implantation of the Carpentier-Edwards Classic Annuloplasty Ring™ led to maximal displacement of mitral annulus, followed by the IM-Ring™, without a statistical significance. In contrary, the implantation of a MyxoETlogix Ring™ was associated with minimal displacement of mitral annulus throughout the groups, but without statistical significance.
The implantation of different ring types in patients with different annuli shapes and dimensions did not lead to any significant change in the configuration of mitral annuli after the virtual implantation of the tested annuloplasty rings.
市面上有不同类型的二尖瓣成形环。本研究的目的是调查六种类型的二尖瓣成形环植入对二尖瓣几何形状和动力学的影响。
获取42例患者的三维超声心动图图像以可视化二尖瓣环。根据前后径，将六种市售二尖瓣成形环的虚拟模型与每位患者的解剖学二尖瓣环进行匹配。测量每种二尖瓣成形环植入后的虚拟位移，并与其他环进行比较。
根据前后径、前后直径和环周长，重度二尖瓣反流患者的瓣环明显扩张。不同程度二尖瓣反流患者的二尖瓣环前后高度和非平面角度无显著差异。在所有具有相同环形形状的组中，前后径与前后径之比几乎相同。植入Carpentier-Edwards Classic Annuloplasty Ring™导致二尖瓣环的最大位移，其次是IM-Ring™，但无统计学意义。相反，在所有组中，植入MyxoETlogix Ring™与二尖瓣环的最小位移相关，但无统计学意义。
在具有不同环形状和尺寸的患者中植入不同类型的环，在虚拟植入测试的二尖瓣成形环后，二尖瓣环的构型没有导致任何显著变化。
