To observe the effect of rigid (Carpentier) and flexible (Duran) annuloplasty rings on the dynamics of the
mitral annulus in patients who had undergone mitral valve repair, 19 patients were studied via a two-dimensional echocardiography. Seven patients had a Carpentier ring and twelve had a Duran annuloplasty
ring. The mitral leaflets and annular attachments were recorded from a veiw close to the standard apical long
axis view. The transducer was rotated and recordings were made at 30° rotational intervals around the
circumference of the mitral valve annulus. To reconstruct the annulus, the diameters (or chords) from each
rotational interval were arranged around a reference point. The annular area were planimetered. The
annular movement was reduced in all 7 patients with a Carpentier ring. In all 12 patients with a Duran ring,
the annular area increased during diastole and became maximum in late diastole. There was some presystolic
narrowing, followed by further systolic narrowing to the minimal size, which was reached in midsystole.
Annular size increased in late systole and in isovolumic relaxation. In 7 patients with a Carpentier ring, the
annular area did not change significantly during cardiac cycle. In conclusion, a flexible Duran annuloplasty
ring is more physiological than a rigid Carpentier ring.