Small rings and edge-to-edge technique elevate transmitral gradients in mitral valve repair

We read with great interest the article by Ma and colleagues1 about elevated gradient after mitral valve repair and the effect of surgical technique and relevance of postoperative atrial fibrillation. Elevated transmitral gradient may cause not only delayed atrial fibrillation but also all other complications associated with pure mitral stenosis, such as left atrial enlargement, thromboembolism, secondary pulmonary hypertension, and delayed right heart failure. In the article of Ma and colleagues,1 the elevated pressure gradient after mitral annuloplasty was due to 2 main surgical problems: the use of small, complete, semirigid rings and the addition of edge-to-edge (E-to-E) repair after ring annuloplasty.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Letter to the Editor Source Type: research