山浦 泰子¹, 吉川 純一　¹, 吉田 清¹, 赤阪 隆史¹, 赤土 正洋¹, 八木 登志員¹, 前西 文秋¹, 岡田 行功²

Yasuko YAMAURA¹, Junichi YOSHIKAWA¹, Kiyoshi YOSHIDA¹, Takashi AKASAKA¹, Masahiro SHAKUDO¹, Toshikazu YAGI¹, Humiaki MAENISHI¹, Yukikatsu OKADA²

¹神戸市立中央市民病院循環器センター内科, ²神戸市立中央市民病院循環器センター胸部外科

¹Department of Cardiology Kobe General Hospital, ²Department of Cardiovascular surgery Kobe General Hospital

キーワード : Mitral annuloplasty ring, Mitral valve repair, Mitral annular motion

To observe the effect of rigid (Carpentier) and flexible (Duran) annuloplasty rings on the dynamics of the mitral annulus in patients who had undergone mitral valve repair, 19 patients were studied via a two-dimensional echocardiography. Seven patients had a Carpentier ring and twelve had a Duran annuloplasty ring. The mitral leaflets and annular attachments were recorded from a veiw close to the standard apical long axis view. The transducer was rotated and recordings were made at 30° rotational intervals around the circumference of the mitral valve annulus. To reconstruct the annulus, the diameters (or chords) from each rotational interval were arranged around a reference point. The annular area were planimetered. The annular movement was reduced in all 7 patients with a Carpentier ring. In all 12 patients with a Duran ring, the annular area increased during diastole and became maximum in late diastole. There was some presystolic narrowing, followed by further systolic narrowing to the minimal size, which was reached in midsystole. Annular size increased in late systole and in isovolumic relaxation. In 7 patients with a Carpentier ring, the annular area did not change significantly during cardiac cycle. In conclusion, a flexible Duran annuloplasty ring is more physiological than a rigid Carpentier ring.