Annuloplasty Ring Utilization in Mitral Valve Repair: A Real-World Snapshot of Device Selection and Early Outcomes

Background: Annuloplasty is a key component of mitral valve repair, yet ring selection remains heterogeneous and its impact on early outcomes is unclear. Methods: This retrospective study included 149 patients undergoing mitral valve repair in whom an annuloplasty ring was utilized. Ring designs were grouped into semi-rigid rings, semi-rigid bands, rigid rings, and other designs. The primary outcome was postoperative atrial fibrillation (AF). Secondary outcomes included early complications and repair durability based on follow-up echocardiography and mortality. Results: Postoperative AF occurred in 35.8% of patients and did not differ across ring designs (p = 0.244). In multivariable analysis, age was independently associated with AF (OR 1.06 per year, p = 0.001), whereas ring design was not. Early outcomes were favorable, with 2.0% mortality and 5.4% rethoracotomy. Follow-up echocardiography showed good or moderate repair in 96.0% of patients; overall repair failure occurred in 4.0% when including mortality, without a clear association with ring design. Conclusions: Annuloplasty ring design was not associated with postoperative AF or early outcomes. Patient-related factors, particularly age, appear more relevant, while early repair durability remains high.