Mid-term results of mitral valve reconstruction by using D-ring and C-flex systems in patients with degenerative mitral valve disease

Objective. The purpose of the research was to compare early and mid-term results following mitral valve repair by using semirigid and flexible annuloplasty rings. Methods. Over a period from September 2011 to September 2014 171 patients with isolated mitral valve insufficiency were recruited and divided in two groups. Mean age in Group I (D-ring) was 57 years (42 to 65), while in group II (C flex) it was 54 years (41 to 63) (р = 0.092). Males constituted more than a half of patients in both groups (69% and 67% respectively). Results. No early deaths (90 days) were registered. There were 4 transient ischemic attacks in group I (p = 0.042). At midterm follow up (24 months) the survival rate in D-ring and C flex groups accounted for 96.0±2.3% (95% CI 88.6-98.7%) and 94.3±2.8% (95% CI 85.5-97.9%) respectively (log-rank test = 0.899); freedom from reoperation ran to 97.0±2.1% (95% CI 88.4-99.3%) and 100% respectively (log-rank test = 0.044); freedom from significant recurrent mitral regurgitation came to 80.8±6.5% (95% CI 64.0-90.3%) and 92.8±3.1 % (95% CI 83.4-97.0%) respectively (log-rank test = 0.002). Conclusion. Using flexible C rings reduces the incidence of postoperative complications and provides better clinical and functional mid-term results as compared to semi-rigid annuloplasty rings in patients with severe mitral regurgitation due to degenerative mitral valve disease.