[Reconstruction of the subvalvular mitral valve tissue in mechanical mitral valve replacement]

Since it was demonstrated in experimental studies that preservation of the subvalvular mitral apparatus is of significance for left ventricular function, it was concluded that in mitral valve replacement complete excision of the mitral valve is disadvantageous for the patient. Clinical experience showed that in patients with mitral regurgitation and large mitral annulus, most of the valvular apparatus can be preserved. In stenotic mitral valve disease, it may be possible to decalcify and mobilize the mitral apparatus and to preserve it. If it is necessary to excise the mitral valve completely, one should think of replacing the chordae tendineae and thus improving postoperative left ventricular function.