Commentary: Signal or noise?

[摘要] Remodeling ring annuloplasty to treat secondary mitral regurgitation due to annular dilatation was described in a series of 157 patients by Alain Carpentier in 1980.1 It is technically straightforward, the saline test is almost always competent, and so is the repair on the postbypass transesophageal echocardiogram. Few surgeons routinely use adjunctive reconstructive techniques or systematically evaluate all such patients at 2 years. This may explain the skeptical response to results of the landmark randomized trial of repair versus replacement for ischemic mitral regurgitation in which recurrent mitral regurgitation in almost 60% of patients was reported 2 years after mitral repair; and the widely prevalent belief that, even if the investigators couldn't consistently achieve durable repairs, the rest of us possessed some secret sauce that would allow us to continue implanting downsized, annuloplasty rings to treat a disease of the ventricle with impunity.

[学科分类] 心脏病和心血管学