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Assessment of mitral annuloplasty ring by cardiac computed tomography: Correlation with echocardiographic parameters and comparison between two different ring types

 Young Joo Suh  ;  Byung-Chul Chang  ;  Dong Jin Im  ;  Yun Jung Kim  ;  Yoo Jin Hong  ;  Geu-Ru Hong  ;  Young Jin Kim 
 Journal of Thoracic and Cardiovascular Surgery, Vol.150(5) : 1082-1090, 2015 
Journal Title
 Journal of Thoracic and Cardiovascular Surgery 
Issue Date
Female ; Heart Valve Prosthesis* ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/instrumentation* ; Hemodynamics ; Humans ; Male ; Middle Aged ; Mitral Valve/diagnostic imaging* ; Mitral Valve/physiopathology ; Mitral Valve/surgery* ; Mitral Valve Annuloplasty/adverse effects ; Mitral Valve Annuloplasty/instrumentation* ; Mitral Valve Stenosis/diagnostic imaging* ; Mitral Valve Stenosis/physiopathology ; Predictive Value of Tests ; Prosthesis Design ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed* ; Treatment Outcome ; Ultrasonography
computed tomography ; functional mitral stenosis ; mitral valve repair ; pannus ; ring annuloplasty
OBJECTIVES: This study investigated computed tomographic (CT) appearance after mitral ring annuloplasty, especially comparing CT findings between patients with normal pressure gradient (PG) and patients with functional mitral stenosis (MS) and between 2 commonly used types of annuloplasty ring. METHODS: A total of 45 cardiac CT scans in patients who underwent mitral ring annuloplasty (Carpentier-Edwards ring, n = 27; Duran ring, n = 18) were retrospectively reviewed. On CT scan, presence of significant pannus around the annuloplasty ring, presence of leaflet thickening, and maximal mitral opening area were analyzed. CT findings were compared between patients with normal PG and patients with functional MS (mean diastolic PG ≥ 5 mm Hg). Incidences of functional MS and CT findings were compared between ring types. RESULTS: Significant pannus was present in 10 cases and leaflet thickening in 31 cases, and maximal opening area was 2.34 ± 0.717 cm(2). Valve opening area on CT was positively correlated with mitral valve area on transthoracic echocardiography and negatively correlated with mean diastolic PG. Mean diastolic PG was significantly elevated with increasing pannus severity. Patients with functional MS had more significant pannus than patients with normal PG. The Duran ring group had higher mean diastolic PG, smaller mitral valve area, and higher incidence of functional MS than the Carpentier-Edwards ring group (P < .05). The proportion of pannus and significant pannus was significantly higher in the Duran ring group (P < .05). CONCLUSIONS: Significant pannus around the annuloplasty ring on CT may cause functional MS after mitral ring annuloplasty. This may occur more frequently with the Duran ring.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
서영주(Suh, Young Joo) ORCID logo https://orcid.org/0000-0002-2078-5832
임동진(Im, Dong Jin) ORCID logo https://orcid.org/0000-0001-8139-5646
장병철(Chang, Byung Chul)
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
홍유진(Hong, Yoo Jin) ORCID logo https://orcid.org/0000-0002-7276-0944
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