Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection
Objectives: To provide an overview that describes the characteristics of a mitral annuloplasty device when treating patients with a specific type of mitral regurgitation according to Carpentier's classification of mitral regurgitation.Methods: Starting with the key search term “mitral valve ann...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.799994/full |
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| author | Johannes H. Jedrzejczyk Johannes H. Jedrzejczyk Lisa Carlson Hanse Lisa Carlson Hanse Shadi Javadian Shadi Javadian Søren N. Skov Søren N. Skov J. Michael Hasenkam J. Michael Hasenkam J. Michael Hasenkam Marcell J. Thørnild Marcell J. Thørnild |
| author_facet | Johannes H. Jedrzejczyk Johannes H. Jedrzejczyk Lisa Carlson Hanse Lisa Carlson Hanse Shadi Javadian Shadi Javadian Søren N. Skov Søren N. Skov J. Michael Hasenkam J. Michael Hasenkam J. Michael Hasenkam Marcell J. Thørnild Marcell J. Thørnild |
| author_sort | Johannes H. Jedrzejczyk |
| collection | DOAJ |
| description | Objectives: To provide an overview that describes the characteristics of a mitral annuloplasty device when treating patients with a specific type of mitral regurgitation according to Carpentier's classification of mitral regurgitation.Methods: Starting with the key search term “mitral valve annuloplasty,” a literature search was performed utilising PubMed, Google Scholar, and Web of Science to identify relevant studies. A systematic approach was used to assess all publications.Results: Mitral annuloplasty rings are traditionally categorised by their mechanical compliance in rigid-, semi-rigid-, and flexible rings. There is a direct correlation between remodelling capabilities and rigidity. Thus, a rigid annuloplasty ring will have the highest remodelling capability, while a flexible ring will have the lowest. Rigid- and semi-rigid rings can furthermore be divided into flat and saddled-shaped rings. Saddle-shaped rings are generally preferred over flat rings since they decrease annular and leaflet stress accumulation and provide superior leaflet coaptation. Finally, mitral annuloplasty rings can either be complete or partial.Conclusions: A downsized rigid- or semi-rigid ring is advantageous when higher remodelling capabilities are required to correct dilation of the mitral annulus, as seen in type I, type IIIa, and type IIIb mitral regurgitation. In type II mitral regurgitation, a normosized flexible ring might be sufficient and allow for a more physiological repair since there is no annular dilatation, which diminishes the need for remodelling capabilities. However, mitral annuloplasty ring selection should always be based on the specific morphology in each patient. |
| first_indexed | 2024-12-20T23:24:45Z |
| format | Article |
| id | doaj.art-6a233305f77f44709e9a72a89b742dc3 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-20T23:24:45Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-6a233305f77f44709e9a72a89b742dc32022-12-21T19:23:26ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-01-01810.3389/fcvm.2021.799994799994Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring SelectionJohannes H. Jedrzejczyk0Johannes H. Jedrzejczyk1Lisa Carlson Hanse2Lisa Carlson Hanse3Shadi Javadian4Shadi Javadian5Søren N. Skov6Søren N. Skov7J. Michael Hasenkam8J. Michael Hasenkam9J. Michael Hasenkam10Marcell J. Thørnild11Marcell J. Thørnild12Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkDepartment of Surgery, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkObjectives: To provide an overview that describes the characteristics of a mitral annuloplasty device when treating patients with a specific type of mitral regurgitation according to Carpentier's classification of mitral regurgitation.Methods: Starting with the key search term “mitral valve annuloplasty,” a literature search was performed utilising PubMed, Google Scholar, and Web of Science to identify relevant studies. A systematic approach was used to assess all publications.Results: Mitral annuloplasty rings are traditionally categorised by their mechanical compliance in rigid-, semi-rigid-, and flexible rings. There is a direct correlation between remodelling capabilities and rigidity. Thus, a rigid annuloplasty ring will have the highest remodelling capability, while a flexible ring will have the lowest. Rigid- and semi-rigid rings can furthermore be divided into flat and saddled-shaped rings. Saddle-shaped rings are generally preferred over flat rings since they decrease annular and leaflet stress accumulation and provide superior leaflet coaptation. Finally, mitral annuloplasty rings can either be complete or partial.Conclusions: A downsized rigid- or semi-rigid ring is advantageous when higher remodelling capabilities are required to correct dilation of the mitral annulus, as seen in type I, type IIIa, and type IIIb mitral regurgitation. In type II mitral regurgitation, a normosized flexible ring might be sufficient and allow for a more physiological repair since there is no annular dilatation, which diminishes the need for remodelling capabilities. However, mitral annuloplasty ring selection should always be based on the specific morphology in each patient.https://www.frontiersin.org/articles/10.3389/fcvm.2021.799994/fullmitral regurgitationmitral annuloplasty devicemitral valve repair (MV repair)mitral ring annuloplastymitral annular forces |
| spellingShingle | Johannes H. Jedrzejczyk Johannes H. Jedrzejczyk Lisa Carlson Hanse Lisa Carlson Hanse Shadi Javadian Shadi Javadian Søren N. Skov Søren N. Skov J. Michael Hasenkam J. Michael Hasenkam J. Michael Hasenkam Marcell J. Thørnild Marcell J. Thørnild Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection Frontiers in Cardiovascular Medicine mitral regurgitation mitral annuloplasty device mitral valve repair (MV repair) mitral ring annuloplasty mitral annular forces |
| title | Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection |
| title_full | Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection |
| title_fullStr | Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection |
| title_full_unstemmed | Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection |
| title_short | Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection |
| title_sort | mitral annular forces and their potential impact on annuloplasty ring selection |
| topic | mitral regurgitation mitral annuloplasty device mitral valve repair (MV repair) mitral ring annuloplasty mitral annular forces |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.799994/full |
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