Complete preservation of mitral valve apparatus versus posterior leaflet preservation only during mitral valve replacement for rheumatic mitral regurgitation

• Main Author: Maged M Kisho
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Medicine in Scientific Research
• Subjects: mitral valve repair; bileaflet augmentation; mitral valve preservation
• Online Access: http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2020;volume=3;issue=3;spage=196;epage=200;aulast=Kisho

Objectives In the present study we investigated whether preservation of both leaflets (anterior and Posterior with subvalvular apparatus) is superior to preservation of the posterior leaflet Alone. Patients and Methods 30 patients who underwent mitral valve replacement in our institute were divided into 2 groups: MVR-C (n=16), in whom both leaflets were preserved, and MVR-P (n=14), in Whom only the posterior leaflet was preserved. The preoperative and postoperative clinical And echocardiographic findings were evaluated. Results No evidence of obstruction at the left ventricular outflow tract was observed in both groups. In the MVR-C group, no deterioration was seen in left ventricular ejection fraction during the early postoperative period, whereas a mild reduction was observed in the MVR-P group (P=0.003). No changes regarding the two groups in their need for inotropic. Agents or in cross-clamp time, duration of ICU or hospital stays, new onset of atrial fibrillation, or mortality rates. Conclusions Bileaflet preservation allows us to avoid the decrease in left ventricular ejection fraction that occurred after preservation of the posterior leaflet alone. In spite of the fact that, posterior leaflet preservation only gives excellent results in decreasing the left ventricular diameter. Bileaflet preservation is considered to be the method of choice to avoid any decreases in ejection fraction and to decrease the incidence of death in patients who present with substantially impaired left ventricular function.