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Immediate clinical results of the new biological support ring for correction of mitral insufficiency

https://doi.org/10.17802/2306-1278-2021-10-4-88-95

Abstract

Aim. To make the first clinical experience evaluation of the new biological closed support ring for mitral valve.

Methods. 26 patients (16 men, 10 women, mean age 55 [49; 62] years) with dysplastic mitral insufficiency were implanted “NEORING” biological ring for the first time from March 2020 to June 2021. The etiological factor of the defect formation in all cases was the connective tissue dysplasia. The mean functional class of heart failure before surgery was 2 [2; 3] according to NYHA, the effective regurgitant orifice (ERO) was 0.4 [0.3; 0.5], vena contracta was 0.7 [0.6; 0.8]. Ten patients received rings of 28 mm diameter, ten patients – 30 mm, six patients – 32 mm.

Results. No significant adverse events such as death from any causes, strokes, myocardial infarction, cardiac complications, bleeding, and return of regurgitation or failure of plastic surgery requiring reoperation, infective endocarditis after the intervention were observed. In two cases a permanent pacemaker was implanted due to sinus node dysfunction. At discharge all patients had no regurgitation (ERO 0), medium transvalvular gradient was 4.0 [3.0; 5.3] mm Hg. All the patients were assigned to NYHA functional class I heart failure after the surgery.

Conclusion. New biological support ring “NEORING” (“NeoKor”, Kemerovo) use in the middle age group of patients showed high hemodynamic efficiency, the absence of specific complications in the early stages after the surgery. It is planned to expand the clinical material on the use of the biological ring, as well as to evaluate the long-term results in the format of a prospective, randomized trial and compare the new device with the existing ones.

About the Authors

I. V. Dvadtsatov
Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Russian Federation

Dvadtsatov Ivan V., Cardiovascular Surgeon at the Cardiac Surgery Department No. 1

6, Sosnoviy Blvd, Kemerovo, 650002



A. V. Evtushenko
Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Russian Federation

Evtushenko Alexei V., PhD., Head of the Laboratory of Heart Disease at the Department of Heart and Vascular Surgery, cardiovascular surgeon at the Cardiac Surgery Department No. 1

6, Sosnoviy Blvd, Kemerovo, 650002



A. N. Stasev
Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Russian Federation

Stasev Alexander N., PhD., senior researcher at the Laboratory of Heart Disease at the Department of Heart and Vascular Surgery, cardiovascular surgeon at the Cardiac Surgery Department No. 1

6, Sosnoviy Blvd, Kemerovo, 650002



A. V. Sotnikov
Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Russian Federation

Sotnikov Anton V., Cardiovascular Surgeon, Head of the Cardiac Surgery Department No.1

6, Sosnoviy Blvd, Kemerovo, 650002



R. N. Komarov
I.M. Sechenov First Moscow State Medical University (Sechenov University), the Ministry of Health of the Russian Federation
Russian Federation

Komarov Roman N., PhD., Professor, Head of the Department of Faculty Surgery No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, Director of the Aortic and Cardiovascular Surgery Clinic at the University Clinical Hospital No. 1 of the Clinical Center, I.M. Sechenov First Moscow State Medical University (Sechenov University), the Ministry of Health of the Russian Federation

bldg. 1, 6, Bolshaya Pirogovskaya St., Moscow, 119435



L. S. Barbarash
Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Russian Federation

Barbarash Leonid S., Academician of the Russian Academy of Sciences, PhD., Professor, Chief Researcher

6, Sosnoviy Blvd, Kemerovo, 650002



References

1. Antoine C., Benfari G., Michelena H.I., Maalouf J.F., Nkomo V.T., Thapa P., Enriquez-Sarano M. Clinical Outcome of Degenerative Mitral Regurgitation: Critical Importance of Echocardiographic Quantitative Assessment in Routine Practice. Circulation. 2018;138(13):1317-1326. doi: 10.1161/CIRCULATIONAHA.117.033173.

2. Carpentier A. La valvuloplastie reconstitutive: une nouvelle technique de valvuloplastie mitrale. Presse Med. 1969;(77):251-3.

3. Ryomoto M., Mitsuno M., Yamamura M., Tanaka H., Sekiya N., Uemura H., Sato A., Ueda D., Miyamoto Y. Physiological mitral annular dynamics preserved after ring annuloplasty in mid-term period. Gen Thorac Cardiovasc Surg. 2017;65(11):627-632. doi: 10.1007/s11748-017-0805-x.

4. Ma W., Ye W., Zhang J., Zhang W., Wu W., Kong Y. Impact of different annuloplasty rings on geometry of the mitral annulus with fibroelastic deficiency: the significance of aortomitral angle. Int J Cardiovasc Imaging. 2018;34(11):1707- 1713. doi: 10.1007/s10554-018-1383-4.

5. Barbarash L.S., Karaskov A.M., Semenov I.I., Zhuravleva I.J., Zhelezchikov V.E., Odarenko J.N., Astapov D.A., Nohrin A.V., Borisov V.V. Infective endocarditis in the structure of dysfunctions of the "KemKor" and "PeriCor" bioprostheses dysfunctions. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2010; 1: 26-30. (In Russian)

6. Hendrix R.J., Bello R.A., Flahive J.M., Kakouros N., Aurigemma G.P., Keaney J.F., Hoffman W., Vassileva C.M. Mitral Valve Repair Versus Replacement in Elderly With Degenerative Disease: Analysis of the STS Adult Cardiac Surgery Database. Ann Thorac Surg. 2019r;107(3):747-753. doi: 10.1016/j.athoracsur.2018.09.018.

7. Bogachev-Prokofiev A. V., Afanasyev A. V., Zhuravleva I. Yu., Demidov D. P., Zhelez-nev S. I., Malakhova O. Yu., Syrtseva Ya. V., Karaskov A M. Pathology of the mitral valve in connective tissue dysplasia. Russian Journal of Cardiology. 2016; 11 (139): 81–86. doi:10.15829/1560-4071-2016-11-81-86 (In Russian)

8. De Bonis M., Alfieri O., Dalrymple-Hay M., Del Forno B., Dulguerov F., Dreyfus G. Mitral Valve Repair in Degenerative Mitral Regurgitation: State of the Art. Prog Cardiovasc Dis. 2017;60(3):386-393. doi: 10.1016/j.pcad.2017.10.006.

9. Carpentier A. Cardiac valve surgery – the «French correction». Thorac Cardiovasc Surg. 1983;86(3):323-37.

10. Perier P., Hohenberger W., Lakew F., Batz G., Urbanski P., Zacher M., Diegeler A. Toward a new paradigm for the reconstruction of posterior leaflet prolapse: midterm results of the "respect rather than resect" approach. Ann Thorac Surg. 2008;86(3):718-25. doi: 10.1016/j.athoracsur.2008.05.015.

11. Ben Zekry S., Lang R.M., Sugeng L., McCulloch M.L., Weinert L., Ramen J., Little S.H., Lawrie G.M., Zoghbi W.A. Quantitation of mitral annular structure and function in organic mitral regurgitation: effect of valve repair and comparison of the modified Carpentier Method with a new “American Correction.” Circulation. 2009;120(18 S):S769.

12. Afanasyev A.V. Mitral valve annuloplasty for connective tissue dysplasia. [dissertation]. Novosibirsk. 2015. (In Russian)

13. Pierce E.L., Gentile J., Siefert A.W., Gorman R.C., Gorman J.H. 3rd, Yoganathan A.P. Real-time recording of annuloplasty suture dehiscence reveals a potential mechanism for dehiscence cascade. J Thorac Cardiovasc Surg. 2016;152(1):e15-7. doi: 10.1016/j.jtcvs.2016.01.043.


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For citations:


Dvadtsatov I.V., Evtushenko A.V., Stasev A.N., Sotnikov A.V., Komarov R.N., Barbarash L.S. Immediate clinical results of the new biological support ring for correction of mitral insufficiency. Complex Issues of Cardiovascular Diseases. 2021;10(4):88-95. https://doi.org/10.17802/2306-1278-2021-10-4-88-95

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ISSN 2306-1278 (Print)
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