Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review

Table 3

Studies comparing RMA ring undersized.

First author (ref. #)	Number of patients	UMA (1 vs. 2 sizes)	Type of surgery	Main findings
Furukawa et al. [8]	14	2 UMA	RMA	Higher rate of MR recurrence in dilated LV
Harmel et al. [10]	50	1 UMA	RMA	Higher rate of MR recurrence
Kainuma et al. [30]	44	2 UMA	RMA	Few rate of MR recurrence  mm; Better improvement of IPMD in favorable LV remodeling
Nappi et al. [34]	48	2 UMA	RMA	Few rate of MR recurrence  mm
Capoulade et al. [32]	126	1 UMA	RMA	Few rate of MR recurrence  mm
Nappi et al. [30]	22	2 UMA	RMA-sr/RMA-dr; 11/11	Few rate of MR recurrence in RMA-dr
Kron et al. [55]	126	1 UMA	RMA	Higher rate of MR recurrence and mitral valve leaflet tethering
Kron et al. [28]	479	1 UMA	RMA-c/RMA-p; 209/270	Higher rate of MR recurrence in RMA-p
Fattouch et al. [12]	55	1 UMA	RMA	Higher rate of MR recurrence in RMA
Langer et al. [61]	30	2 UMA	RMA	Higher rate of leaflet tethering in dilated LV
McGee et al. [18]	585	1UMA	RMA-rr/RMA-fr; 396/122	After 1 yrs 3+ or 4+ MV regurgitation increased (). Similar results in rr vs. fr

RMA: restrictive mitral annuloplasty; c: complete; dr: double row; fr: flexible ring; p: partial; rr: rigid ring; sr: single row; UMA: undersized mitral annuloplasty. See text for other abbreviations.