Annuloplasty

Surgical procedure to repair heart valves

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Uses
Complications
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Annuloplasty is a surgical procedure aimed at repairing and reconstructing the heart valve annulus, which is the ring-like structure that supports the valve leaflets. This procedure is commonly performed to treat valvular heart disease, particularly in cases of mitral valve regurgitation and tricuspid valve regurgitation.

Indications

Annuloplasty is indicated in patients with:

• Mitral valve regurgitation: This condition occurs when the mitral valve does not close properly, allowing blood to flow backward into the left atrium.
• Tricuspid valve regurgitation: Similar to mitral regurgitation, this involves the tricuspid valve, affecting blood flow between the right atrium and right ventricle.
• Heart failure: In some cases, annuloplasty can help improve heart function by restoring proper valve function.

Procedure

The annuloplasty procedure involves the following steps:

1. Accessing the Heart: The surgeon typically accesses the heart through a median sternotomy or a less invasive approach such as a thoracotomy.

2. Exposing the Valve: The affected valve is exposed, and the annulus is assessed for dilation or deformation.

3. Implanting the Annuloplasty Ring or Band: A prosthetic ring or band is sewn onto the annulus to reshape and stabilize it. This can be a complete ring or a partial band, depending on the specific needs of the patient.

4. Testing Valve Function: After the ring or band is secured, the valve is tested to ensure proper closure and function.

5. Closing the Incision: The surgical site is closed, and the patient is monitored for recovery.

Types of Annuloplasty Devices

Annuloplasty devices can be classified into:

• Rigid Rings: These provide a fixed shape and are used when significant support is needed.
• Flexible Rings: These allow for some natural movement of the valve annulus.
• Semi-rigid Rings: These offer a balance between rigidity and flexibility.

Complications

Potential complications of annuloplasty include:

• Bleeding
• Infection
• Thrombosis
• Valve dysfunction or failure

Prognosis

The prognosis after annuloplasty is generally favorable, with many patients experiencing improved valve function and relief from symptoms. Long-term outcomes depend on the underlying condition and the presence of other comorbidities.

Also see

• Mitral valve repair
• Tricuspid valve repair
• Heart valve surgery
• Cardiothoracic surgery