987-104 Flexible Annuloplasty Support Preserves Physiological Annular Movement and Non-planar Shape: A 3-Dimenslonal Intraoperative Echocardiographlc Study

Mitral annular motion and nonplanar shape has been shown to be important to normal valve dynamics and left ventricular systolic function. We evaluated the effect of a new flexible annuloplasty ring on the morphology and motion of the mitral annulus in patients undergoing mitral repair.MethodsThe mitral valve was imaged over one complete cardiac cycle at ≈10° rotations using a multiplane transesophageal probe in 4 patients intraoperatively after mitral repair. Two had data pre and post repair for a total of 6 reconstructions. The data were digitized off-line and annular insertion points and ring location (post-op) were identified for each frame of data over the cardiac cycle (≈ 1000 points per reconstruction). The data were reconstructed in 3-D, and a least-square plane was fit. The following measures were obtained: A) annular area as projected onto the least-squares plane B) Atrio-ventricular motion of the annulus C) non-planarity of the annulus (mean-square- deviation from the least-squares fit plane).ResultsAll the patients maintained the non-planarity with a maximal deviation from the plane of 8.6mm. The mean atrio-ventricular motion was 2.6mm and the % change in area during the cardiac cycle was 14.7%. For the 2 patients with pre and post repair data, there was a reduction in total area of 59%, an increase of 18% in non-planarity and a reduction of maximal excursion of 47%.ConclusionThis preliminary study shows that annuloplasty repair with a flexible ring preserves annular motion and nonplanarity while allowing significant reduction in annular area