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Recurrence of Mitral Regurgitation after Partial versus Complete Mitral Valve Ring Annuloplasty
Michael H. Kwon, MD1, Lawrence S. Lee, MD1, Marisa Cevasco, MD, MPH1, Gregory S. Couper, MD1, Prem S. Shekar, MD1, Lawrence H. Cohn, MD1, Frederick Y. Chen, MD, PhD1
1Brigham and Women's Hospital, Division of Cardiac Surgery, Boston, MA

Background: Both partial and complete annuloplasty rings are used for mitral valve repair in patients with functional mitral regurgitation (FMR). We sought to determine whether the recurrence of mitral regurgitation was affected by the type of ring used. Methods: 548 patients diagnosed with FMR underwent mitral valve repair with ring annuloplasty between 1998 and 2008 in our institution. Medical records were reviewed retrospectively for clinical and echocardiographic data to determine the presence of recurrent MR (defined as moderate or severe). Results: Among 479 patients for whom postoperative echocardiographic data were available, recurrent MR occurred less frequently in the complete v. partial ring group [20 (10%) of 209 v. 56 (21%) of 270 patients, p = 0.001], despite lower preoperative ejection fractions in the complete ring group (median 35%, IQR 25-45% v. 40%, IQR 30-55%, p < 0.001). Kaplan-Meier analysis demonstrated greater freedom from recurrent MR in the complete ring group (108 v. 103 months, p = 0.001). Risk-matched propensity analysis of 102 patients per group (AUC = 0.824, 95% confidence interval 0.788-0.861, p < 0.001) also demonstrated that complete ring recipients had greater freedom from recurrent MR than partial ring recipients by univariate analysis [7 (7%) v. 17 (17%) patients, p = 0.049], and a trend towards greater freedom by Kaplan-Meier analysis (110 v. 104 months, p = 0.068). Conclusions: The use of complete mitral annuloplasty rings provides improved freedom from recurrent MR in patients with FMR.


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