scholarly journals The evaluation of the post operative left ventricular function in the case of aortic and mitral valve replacement.

1988 ◽  
Vol 18 (1) ◽  
pp. 71-73
Author(s):  
H. Masuda
Keyword(s):  
Mitral Valve ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Ventricular

Surgery for Degenerative Mitral Regurgitation Valve Repair v. Valve Replacement with Chordal Preservation

1994 ◽  
Vol 2 (2) ◽  
pp. 90-94
Author(s):  
Masaharu Shigenobu ◽  
Shunji Sano
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Valve Repair ◽  
Repair Group

This study compares mitral valve repair and mitral valve replacement with chordal preservation for chronic mitral regurgitation due to myxomatous degeneration with special reference to left ventricular function. Twenty-six patients underwent complete preoperative and 2 years later postoperative echocardiography study. Thirteen patients underwent mitral valve replacement associated with preservation of chordae tendineae and papillary muscles, and 13 patients had mitral valve repair. There were no statistically significant differences between the 2 groups for clinical findings, hemodynamic profiles, or left ventricular function compared prior to surgery. After correcting mitral regurgitation, increase in cardiac index was significant for the repair group. Left ventricular end-diastolic volume decreased in both groups. Left ventricular end-systolic volume significantly decreased in the repair group, but remained unchanged in the replacement group. Both ejection fraction and mean left ventricular circumferential fiber shortening velocity (mVcf) decreased in the replacement group, but significantly increased in the repair group 2 years after surgery. These findings suggest valve replacement with chordal preservation shows less improvement in ventricular systolic function late after surgery compared with mitral valve repair.

Complete Preservation of the Mitral Valve Apparatus during Mitral Valve Replacement for Rheumatic Mitral Regurgitation in Patients with an Enlarged Left Ventricular Chamber

2013 ◽  
Vol 16 (3) ◽  
pp. 137 ◽  
Author(s):  
Lin Chen ◽  
Baicheng Chen ◽  
Jia Hao ◽  
Xuefeng Wang ◽  
Ruiyan Ma ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Early Death ◽  
Left Ventricular ◽  
Anatomical Position ◽  
Left Ventricular Chamber

<p><b>Background and Aims:</b> The merits of retaining the subvalvular apparatus during mitral valve replacement (MVR) for chronic mitral regurgitation have been demonstrated in clinical investigations. This study was to investigate the feasibility of total preservation of the leaflet and subvalvular apparatus at the native anatomic position during MVR in a rheumatic population with enlarged left ventricular chamber.</p><p><b>Material and Methods:</b> The techniques of valvular apparatus preservation used during MVR with or without aortic valve replacement were investigated in 128 patients with an enlarged left ventricular chamber suffering from rheumatic mitral regurgitation between October 2003 and December 2007. Seventy patients had the anterior leaflet and subvalvular apparatus excised but the posterior leaflet and subvlvular apparatus preserved during the mitral valve replacement (P-MVR group), and 58 patients had the anterior and posterior mitral leaflets and the subvalvalur apparatus completely preserved at the native anatomical position during the mitral valve replacement (C-MVR group). Echocardiography was performed preoperatively, at discharge, and after 3 months, 1 year, and 3 years to determine the left ventricular dimensions and function.</p><p><b>Results:</b> There were 2 cases (3.4%) of early death in the C-MVR group, and there were 4 cases (5.7%) of early death in the P-MVR group. There were 3 cases of late death 1 year after surgery, of which 1 case in the C-MVR group was caused by congestive heart failure and the other 2 cases in the P-MVR group were due to sudden death. Both groups exhibited significant improvement (<i>P <</i> .05) in left ventricular function instantly and late postoperatively. The reduction of the left ventricular end-diastolic diameter was more significant in the C-MVR group as compared to the P-MVR group (<i>P <</i> .05). A statistically significant increase in fractional shortening (FS) occurred in the C-MVR group compared to the P-MVR group.</p><p><b>Conclusion:</b> This study shows that complete mitral leaflet preservation at the native anatomical position during MVR is feasible in rheumatic patients with an enlarged left ventricular chamber and confers significant short-term and long-term advantages by preserving left ventricular function and geometry. Therefore, it is a safe, simple, and effective surgical technique and should be individualized during clinical use.</p>

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