Annuloplasty refers to the implantation of a reinforcing ring on a heart valve after a surgical repair. The ring helps to maintain the size of the valve to prevent regurgitation, where it starts to leak and the heart works less efficiently. Many cardiac surgeons include annuloplasty with valve repair or recommend it to their patients, with the goal of making the repair last longer and work more effectively. Patient outcomes can vary, depending on their medical history, the surgeon, and the specifics of the repair surgery.
Valves inside the heart allow blood to move from chamber to chamber with the heartbeat. They rely on a set of flexible leaflets to allow blood to push into the neighboring chamber without back flowing. People with heart failure and certain other conditions can experience regurgitation, where the blood leaks into the previous chamber of the heart, which interferes with heart function. Individual valves can also be subject to narrowing, known as stenosis, which forces the heart to work much harder to pump blood.
In valve repair surgery, a doctor can expose the heart, remove damaged tissue, reinforce the valve, and realign leaflets and other components as necessary. If the surgeon decides to add an annuloplasty, once the repair is finished, a ring can be seated around the valve. Materials used in annuloplasty rings are flexible so they can move with the heart while still maintaining the size and shape of the valve to help it last in the long term.
The alternative is a valve replacement, where the surgeon implants a new valve, which may be artificial or taken from an animal donor. Repairs can have better patient outcomes and are less prone to problems like clotting, although there is still a risk the repaired valve could fail in the future. Annuloplasty can help extend the life of the valve after reconstruction by adding reinforcement and strength to the tissue.
Patients interested in the mechanics of their valve repair surgeries can ask to see a sample of the annuloplasty ring, and the surgeon should be able to briefly describe what will happen during the procedure. A number of products are on the market and surgeons typically have a preference based on experience with other patients. People can ask about the advantages of a specific annuloplasty ring and why the surgeon prefers it if they want more information. Regulation of medical devices is variable by nation and patients may want to be aware that some countries don’t require clinical trials to demonstrate efficacy and safety for equipment like annuloplasty rings.