Mitral Valvuloplasty using New Mitral Strip (Mitracon(R))

Kang, Seong Sik; Kim, Sang Pil; Song, Meong Gum

Abstract

BACKGROUND: Numerous surgical devices for mitral repair have been used in the past with good results. In this study we describe a simple annuloplasty technique with using a new device (Mitracon(R)). The aim of this study was to assess its efficacy and surgical results with using Mitracon. MATERIAL AND METHOD: From May 2003 to October 2005, 46 patients (21 women and 25 men (mean age of 51.4+/-17.8 years) with mitral regurgitation from various causes were treated with either the Mitracon(R) (the Mitracon group) or the Capentier Edward rigid ring(R) (the CE group). The median follow-up duration was 18.9 months. RESULT: The mean grade of mitral regurgitation before and immediately after surgery in the Mitracon group and the CE group decreased from 3.2+/-0.8 to 0.6+/-0.7 and 3.4+/-0.7 to 0.3+/-0.5, respectively. There were no significant changes in the ejection fraction either between the two groups or before and immediately after surgery. No deaths were seen in either group. Early postoperative echocardiography of all 46 patients showed only trivial mitral regurgitation or none at all. Echocardiography at a median of 18.9 months also showed no progression in mitral regurgitation. The mean grade of mitral regurgitation in the Mitracon group at this time point decreased from 3.2+/-0.8 to 0.8+/-0.7 (p<0.05). The CE group also showed a similar degree of decrease from 3.4+/-0.7 to 0.3+/-0.6 (p<0.05). The mitral valve area in the Mitracon group at 1 year follow-up was 3.3+/-0.9 cm(2). The mitral valve area in the CE group was 2.7+/-0.6 cm(2). The mean mitral pressure gradient in the Mitracon group at 1 year follow-up was 3.1+/-1.3 mmHg. The mean pressure gradient in the CE group was 4.5+/-2.1 mmHg, although any statistical significant difference for this between the groups was not reached.
CONCLUSION
The present study showed the described technique to be safe and effective in the intermediate term. Because long term results are unavailable, a more extensive prospective randomized multicenter trial may be warranted to determine whether this procedure should be generally applied for repair of mitral valve disease.