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Interrupted Commissural Band Annuloplasty Prevents Mitral Stenosis

Interrupted Commissural Band Annuloplasty Prevents Mitral Stenosis

Masaru Sawazaki, Shiro Tomari, Kenta Zaikokuji, Yusuke Imaeda

Gen Thorac Cardiovasc Surg. 2016 Sep;64(9):524-8.

PMID: 27225485

Abstract:

Background:
Mitral annuloplasty is an important component of the treatment of degenerative mitral valve disease. However, postoperative echocardiography reveals elevated mitral gradients in some patients. We developed a technique that we termed interrupted commissural band annuloplasty (iCBA), which does not shorten either the anterior or posterior annulus and is not associated with the development of a mitral gradient. We compared the echocardiographic characteristics of patients treated using this method versus Cosgrove ring (COS) placement, both at rest and during exercise.
Methods:
ICBA features placement of three sutures in the commissures using two bands and shortens the commissural annular length by 60 %. We used this method to treat 63 patients and placed Cosgrove bands in 58. Of all patients, 48 who underwent iCBA and 34 with COSs passed the exercise echocardiographic test.
Results:
The maximal transmitral pressures at rest in the iCBA and Cosgrove groups were 8.04 ± 0.74 and 11.30 ± 0.88 mmHg (P = 0.0029), respectively, and the mean transmitral pressures at rest were 2.46 ± 0.74 and 3.61 ± 0.32 mmHg (P = 0.0037), respectively. The maximal transmitral pressures during exercise were 11.79 ± 0.97 and 18.37 ± 1.16 mmHg (P < 0.0001), and the mean transmitral pressures during exercise were 4.95 ± 0.45 and 7.76 ± 0.53 mmHg (P < 0.0001).
Conclusions:
ICBA prevents postoperative mitral stenosis both at rest and importantly during exercise.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP1207461571	ICBA		1207461-57-1	Price

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