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 the impact of ring design on early outcomes remains unclear. Methods: This retrospective study included 153 consecutive patients undergoing mitral valve repair with annuloplasty. Ring designs were grouped into semi-rigid rings, semi-rigid bands, rigid rings, and other designs. The primary outcome was new-onset postoperative atrial fibrillation (AF). Secondary outcomes included early complications and repair durability based on follow-up echocardiography. Results: Postoperative AF occurred in 14.4% of patients and did not differ across ring design groups (p = 0.791). No independent predictors of AF were identified, although a longer aortic cross-clamp time showed a borderline association. Early outcomes were favorable, with 2.0% mortality and 5.9% rethoracotomy. Follow-up echocardiography was available in 79.7% of patients, with good or moderate repair observed in 95.9%. Echocardiographic repair failure occurred in 2.5% of patients. No clear association was observed between ring design and repair durability. Conclusions: In this real-world cohort, no significant association was detected between annuloplasty ring design and early postoperative AF or short-term outcomes. These findings should be interpreted cautiously, given the low event rate and small subgroup sizes.