Mitral valve repair: Is there still a place for suture annuloplasty?

Department of Cardiac Surgery, Ospedale Niguarda Cà Granda, Milan, Italy.
Asian cardiovascular & thoracic annals 09/2007; 15(4):351-8. DOI: 10.1177/021849230701500420
Source: PubMed


Prosthetic ring annuloplasty is considered the gold standard technique for mitral valve repair, but it has been associated with some drawbacks. Suture annuloplasty is less expensive and may have some physiopathologic advantages. We reviewed the literature to assess clinical results of mitral suture annuloplasty. Thirteen series, each reporting more than 50 patients and published in the last 10 years, were included in the analysis. They comprised 1,648 patients with cumulative follow-up of 5,607 patient-years. Our review suggests that suture annuloplasty is a safe procedure, but a trend toward recurrence of annular dilatation with time was reported. In selected cases, suture annuloplasty is effective, and its mid-term clinical results are encouraging and compare well with those of prosthetic ring repair series. The quality of the results varies according to the particular annuloplasty technique used and to the mitral valve pathology treated. Recent technical modifications have been found to decrease the incidence of repair failure and promise to improve the reproducibility of the procedure. Further investigations are warranted to better assess the long-term results of suture annuloplasty, and to determine whether its theoretical functional advantages translate into a real clinical benefit.

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    • "Annuloplasty is an essential component of mitral valve repair whether it is performed with, or without, a prosthetic ring. Currently, ring annuloplasty is considered as the gold standard although some unfavorable pathophysiologic effects have been identified in experimental and clinical studies.[2] On the other hand, suture annuloplasty is preferred by some authors for some of its advantages.[3],[4] "
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