Initial experience of mitral valve repair using the Physio Flex Annuloplasty Ring.

Purpose: This study evaluated the early clinical and echocardiographic outcomes of mitral valve (MV) repair using the Physio Flex Annuloplasty Ring for mitral regurgitation (MR) of various etiologies.

Methods: We retrospectively analyzed 185 patients who underwent MV repair using Physio Flex Annuloplasty Ring between July 2020 and October 2024. Degenerative MR was the most common type (n = 94), followed by functional MR (n = 79). Severe and moderate MR were observed in 126 and 59 patients, respectively.

Results: Artificial chordal reconstruction, leaflet resection, and folding plasty were performed in 61 (33.0%), 21 (11.4%), and 13 (7.0%) patients, respectively, whereas ring annuloplasty alone was performed in 64 (34.6%) patients. The median ring size was 30 mm (interquartile range, 30-32mm). The operative mortality rate was 2.2%. Postoperatively, no/trivial and mild MR were observed in 162 (87.6%) and 18 (9.7%) patients, respectively. Left ventricular end-diastolic and end-systolic diameters significantly decreased from 51 ± 8 mm to 47 ± 7 mm and from 34 ± 9 mm to 32 ± 8 mm, respectively (P < 0.001). The right ventricular systolic pressure also decreased (33 ± 13 mmHg to 29 ± 10 mmHg; P < 0.001). Functional mitral stenosis (mean transmitral pressure gradient of ≥ 5 mmHg) occurred in 13 patients.

Conclusion: MV repair using the Physio Flex Annuloplasty Ring provides effective MR control and satisfactory early outcomes, with an acceptable incidence of functional mitral stenosis.