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Carpentier-Edwards Physio II Annuloplasty Ring for Mitral Valve Repair: Mid-Term Outcome in 501 Consecutive Patients
Franz Sieg, MD, Mateo Marin Cuartas, MD, Ricardo Spampinato, MD, Philipp Kiefer, MD, Fabian Emrich, MD, David Holzhey, MD PhD, Martin Misfeld, MD PhD, Piroze Davierwala, MD, Michael A. Borger, MD PhD, Jörg Seeburger, MD PhD, Thilo Noack, MD.
Herzzentrum Leipzig, Leipzig, Germany.

OBJECTIVE: The Carpentier-Edwards (CE) Physio II annuloplasty ring is used for the surgical mitral valve repair (MVR) in patients with mitral regurgitation (MR). The aim of this study was to evaluate the mid-term outcome of MVR with the CE Physio II ring.
METHODS: Between 2011 and 2016, a total of 501 consecutive patients underwent MVR for MR using the Physio II ring. Mean-age was 55.0 ± 12.1 years, 372 patients (74.3%) were males, and 90 patients (17.9%) presented atrial fibrillation. Mean left ventricular ejection fraction (LVEF) was 62.0 ± 7.7%. Mean logistic EuroSCORE was 2.7 ± 2.5%. 145 (28.7%) patients presented preoperatively functional NYHA classification III-IV.
RESULTS: Isolated MVR was performed via a right-sided mini-thoracotomy in 490 patients (97.8%), and via sternotomy in 11 patients (2.2%). Concomitant procedures consisted of treatment of atrial fibrillation (MAZE) in 87 patients (17.4%) and closure of atrial septum defect in 88 patients (17.6%). Median size of implanted annuloplasty rings was 34 mm (range: 28-40 mm). Mean bypass time was 115.4 ± 34.2 min and mean cross-clamp time was 73.3 ± 24.7min. One patient had a mild MR directly postoperatively. 36 Patients (7.2%) had to be reoperated due to thoracic bleeding.
Thirty-day mortality was 0.6%. The Kaplan-Meier estimate for 1-year and 4-year survival was 98.5 ± 0.4% and 98.5% ±0.4%, respectively. Freedom from MV reoperation was 96.1% at 4 years.
CONCLUSIONS: MVR with the CE Physio II annuloplasty ring can be performed with excellent clinical results.


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