Physiological Changes of the Mitral Annulus After Annuloplasty in Barlow Disease

University Hospital, Basel, Switzerland10 enrolled

Overview

Barlow disease (BD) is a common cause of mitral insufficiency. In 2012 the University Hospital of Basel started to perform a simplified mitral valve repair technique in BD just by implanting an annuloplasty-ring. It is hypothesized that the major mechanism of the valvular insufficiency in Barlow disease is a deformation of the left ventricle and the posterior mitral annulus, causing its aberrant displacement during the systole towards posterior and basal and thus impairing the coaptation of the leaflets. This prospective individual MRI study is to investigate the ventricle and the mitral annulus pre- and postoperatively for detailed analysis.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Barlow Disease (BD)Mitral Insufficiency

Interventions

Magnetic resonance imaging (MRI)DIAGNOSTIC_TEST

MRI pre- and postoperatively for detailed analysis of the ventricle and the mitral annulus. The first MRI will be performed on the admission day before surgery. The second MRI will be performed during the hospital stay, between 3 and 7 days after the operation. The MRI images are interpreted through a specialized cardiologist and radiologist.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * identified Barlow disease suffering from significant mitral insufficiency with indication to surgery Exclusion Criteria: * Active endocarditis or any other etiology of mitral insufficiency else than Barlow disease * Inability to perform a cardiac MRI (e.g., metallic implants, claustrophobia) * Pregnancy * Inability to give consent

Outcomes

Primary Outcomes

Change in anatomical structures by MRI

Change in anatomical structures by MRI: distance (mm) between the mitral annulus and the cardiac apex during the cardiac cycle before and after surgical correction

Time frame: The first MRI will be performed on the admission day before surgery. The second MRI will be performed during the hospital stay, between 3 and 7 days after the operation.

Secondary Outcomes

function of the mitral valve by echocardiography

association between reduction of movement of the posterior annulus and the function of the valve after surgery (i.e. its residual insufficiency (0 = absent, 1 = mild, 2 = moderate, 3 = severe)). Evaluated with echocardiography as it is routinely performed in cardiac surgery.

Time frame: during the hospital stay, between 3 and 7 days after the operation and at cardiological follow-up over the first 3 months.

Central Contacts

Martin Grapow, Prof. Dr. med.

CONTACT

+41 44 3873711 grapow@herzzentrum.ch

Thibault Schaeffer