Mitral annulus morphologic and functional analysis using real time tridimensional echocardiography in patients submitted to unsupported mitral valve repair

Introduction

Mitral valve repair is the treatment of choice to correct mitral insufficiency,although the literature related to mitral valve annulus behavior after mitralrepair without use of prosthetic rings is scarce.

Objective

To analyze mitral annulus morphology and function using real time tridimensionalechocardiography in individuals submitted to mitral valve repair with DoubleTeflon technique.

Methods

Fourteen patients with mitral valve insufficiency secondary to mixomatousdegeneration that were submitted to mitral valve repair with the Double Teflontechnique were included. Thirteen patients were in FC III/IV. Patients wereevaluated in preoperative period, immediate postoperative period, 6 months and 1year after mitral repair. Statistical analysis was made by repeated measures ANOVAtest and was considered statistically significant P<0.05.

Results

There were no deaths, reoperation due to valve dysfunction, thromboembolism orendocarditis during the study. Posterior mitral annulus demonstrated a significantreduction in immediate postoperative period (P<0.001),remaining stable during the study, and presents a mean of reduction of 25.8%comparing with preoperative period. There was a significant reduction inanteroposterior and mediolateral diameters in the immediate postoperative period(P<0.001), although there was a significant increase inmediolateral diameter between immediate postoperative period and 1 year. There wasno difference in mitral internal area variation over the cardiac cycle during thestudy.

Conclusion

Segmentar annuloplasty reduced the posterior component of mitral annulus, whichremained stable in a 1-year-period. The variation in mitral annulus area duringcardiac cycle remained stable during the study.