Abstract
Reconstruction of cardiac valves is associated with reduced mortality, including in
multiple valve surgery. However, multiple valve repair is still considered a challenge,
even with established techniques. Recently, internal aortic ring annuloplasty has
been introduced and could simplify multiple valve reconstruction. This study reports
early results with double ring aortic and mitral valve repair. Three patients with
bivalvular degenerative regurgitation were managed with combined aortic and mitral
valve repair using double rings. Mean (±SD) age was 41 ± 21 years, preoperative left
ventricular end-diastolic volume was 119 ± 53 mL/m2, and ejection fraction was 0.50 ± 0.07. Mean aortic ring diameter was 21 mm, and
mitral rings averaged 32 mm. No operative mortalities or major complications were
observed. No valve-related events occurred. Postoperative echo showed complete resolution
of mitral and aortic regurgitation. Postoperative left ventricular end-diastolic volume
decreased to 98 ± 10 mL/m2; no left ventricular outflow tract obstruction or significant transvalvular gradients
were observed. Postoperative cardiac CTs showed an optimal three-dimensional configuration
of aortic and mitral annuloplasty devices. This initial series demonstrated the feasibility
and safety of combined aortic and mitral repair with double rings. Clinical and hemodynamic
results were promising. Increasing application and more clinical experience with combined
aortic and mitral double ring repair seems indicated.
Keywords
aortic valve repair - mitral valve repair - ring implantation
