Mitral rings: Are theory and practice same?

Abstract

Approach to mitral valve and the subject of the ring to be used was very simple in the terms of which direct and indirect imaging methods and endoscopic surgery were not as developed as they are today. If the valves and structures beneath the valve are undamaged or repairable, a ring of an appropriate extent was being put to narrow the expanded anulus and the result could exactly be tested in postoperative intensive care. However, today, functional anatomy and pathology of mitral valve and its structures, before surgery, during and after sugery are well understood with the highly developed imaging methods. Particularly no acting of mitral valve on a flat plane during systole-diastole, being in a saddle shape, complication of its functional anatomy and its motion and especially SAM (systolic anterior motion) case, have brought the obligation of surgical methods to be different and selective which will be chosen in accordance with pathology. A ring not being selected correctly and the surgical repair may cause the patient to be worse than pre-operation and may even cause mortality. In this study, the rings chosen on the basis of functional anatomy and patho-logy of mitral valve and important points of surgery were analyzed and discussed.