Flexibility of the mitral annulus with the Duran ring at six years post-implantation.

Abstract Although, in theory, the mitral annulus with the Duran flexible ring should change size and shape during the cardiac cycle, no clinical reports are available of such flexibility several years after surgery. The study aim was to evaluate mitral annulus flexibility at medium-term follow up after surgery. Eleven patients (mean age 60+/-8 years) were enrolled for this study. All were in sinus rhythm and had less than mild residual mitral regurgitation. The mean time between study and mitral valve repair was 6.0+/-2.4 years. Three sizes of Duran ring were used (three size 27, six size 29, and two size 31). All patients were studied with transesophageal echocardiography. The mitral annulus was reconstructed 10 times around a single axis of rotation during the cardiac cycle, using published methods. The area, circumferential length and shape of the mitral annulus were analyzed at various times during the cardiac cycle. A significant change in mitral annular area occurred during the cardiac cycle; the maximum to minimum reduction was 23+/-8% (p