1200 Rev Esp Cardiol. 2010;63(10):1200-4 Mitral Valve Repair for Ischemic Mitral Regurgitation Using the Carpentier-McCarthy-Adams IMR ETlogix ® Ring: Medium-Term Echocardiographic Findings Víctor X. Mosquera, a Alberto Bouzas-Mosquera, b Francisco Estévez, a José M. Herrera, a Vicente Campos, a Francisco Portela, a Nemesio Álvarez, b and José J. Cuenca a a Servicio de Cirugía Cardiaca, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain b Servicio de Cardiología, Laboratorio de Imagen, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain BRIEF REPORT Correspondence: Dr. V.X. Mosquera Rodríguez. Servicio de Cirugía Cardiaca. Complexo Hospitalario Universitario A Coruña. As Xubias, 86. 15006 A Coruña. Spain. E-mail: victor.x.mosquera.rodriguez@sergas.es Received March 31, 2009. Accepted for publication October, 2009. The aims of this study were to review the principles underlying use of the Carpentier-McCarthy-Adams IMR ETlogix ® asymmetric annuloplasty ring for the treatment of chronic ischemic mitral regurgitation and to report medium-term clinical outcomes observed at our center. The in-hospital mortality rate was 2.8%. Echocardiography at hospital discharge confirmed the absence of mitral regurgitation in 88.8% of patients. Patients underwent clinical and echocardiographic follow- up (median duration, 23 months; range, 12-44 months). Late follow-up echocardiography demonstrated the recurrence of moderate mitral regurgitation in 5.7% of patients and of moderate-to-severe mitral regurgitation in 2.9%. The rate of survival free from recurrence of ≥grade-2 mitral regurgitation was 95.2% at 15 months and 88.9% at 25 months. Mitral valve repair using the asymmetric Carpentier-McCarthy-Adams IMR ETlogix ® ring in patients with chronic ischemic mitral regurgitation enabled regurgitation to be effectively corrected by producing asymmetric changes in the morphology of the mitral ring. Medium-term outcomes, with regard to the degree of mitral valve competence, were excellent. Key words: Myocardial ischemia. Mitral regurgitation. Valvuloplasty. Remodeling. Reparación mitral de la insuficiencia mitral isquémica con anillo Carpentier- McCarthy-Adams IMR ETlogix ® : resultados ecocardiográficos a medio plazo En este estudio revisamos los fundamentos del anillo asimétrico Carpentier-McCarthy-Adams IMR ETlogix ® en el tratamiento de la insuficiencia mitral isquémica cróni- ca y exponemos la experiencia a medio plazo de nuestro centro. La mortalidad hospitalaria fue del 2,8%. El eco- cardiograma al alta constató la ausencia de regurgitación mitral en el 88,8% de pacientes. Se obtuvo seguimiento clínico y ecocardiográfico (mediana, 23 meses; intervalo, 12-44 meses). El ecocardiograma de control tardío mos- tró recidiva de insuficiencia mitral de grado moderado en el 5,7% de pacientes y grado moderado-severo en el 2,9%. La supervivencia libre de recidiva de insuficiencia mitral ≥ 2+ fue del 95,2% a los 15 meses y del 88,9% a los 25 meses. La reparación mitral con anillo asimétrico Carpentier-McCarthy-Adams IMR ETlogix ® en pacientes con insuficiencia mitral isquémica crónica permite una eficaz corrección de la regurgitación a través de cambios asimétricos en la morfología del anillo mitral, con exce- lentes resultados a medio plazo en cuanto al grado de competencia mitral. Palabras clave: Isquemia miocárdica. Insuficiencia mitral. Valvuloplastia. Remodelado. INTRODUCTION Chronic ischemic mitral valve regurgitation (CIMR) is an increasingly important problem due to its substantial incidence and clinical repercussions. In recent years, several studies have shown that when left uncorrected CIMR leads to a worse prognosis in patients with coronary disease. Hence, many authors currently recommend simultaneous mitral valve repair and surgical revascularization even in patients with moderate CIMR. 1,2 The most common mechanism in CIMR is restricted leaflet motion, especially of the posterior leaflet during systole (Carpentier’s type IIIB dysfunction) 3 due to subvalvular apparatus tethering. 4 The Carpentier-McCarthy- Adams IMR ETlogix ® prosthetic ring (CMA IMR ETlogix; Edwards Lifescience, Irvine, California, USA) was designed on the basis of