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Related Experiment Videos

Effect of chordal preservation on left ventricular function.

Nagarajan Muthialu1, Shashi K Varma, Sundar Ramanathan

  • 1Department of Cardiothoracic & Vascular Surgery, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, India. prathi_naga@hotmail.com

Asian Cardiovascular & Thoracic Annals
|August 23, 2005
PubMed
Summary

Preserving the chordae tendineae during mitral valve replacement surgery significantly improves patient survival and cardiac function compared to complete valve excision. This approach enhances functional status and preserves left ventricular geometry.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Mechanics
  • Valvular Heart Disease

Background:

  • Mitral valve replacement is a common procedure for valvular heart disease.
  • Conventional mitral valve replacement involves complete excision of the native valve.
  • The impact of preserving subvalvular structures on postoperative cardiac function and survival is debated.

Purpose of the Study:

  • To compare outcomes of mitral valve replacement with chordopapillary apparatus preservation versus conventional valve excision.
  • To evaluate the effect of chordal preservation on left ventricular function and long-term survival.

Main Methods:

  • Retrospective analysis of 360 patients undergoing mitral valve replacement.
  • Comparison between 98 patients with chordal preservation (total or partial) and 262 patients with conventional valve excision.

Related Experiment Videos

  • Assessment of left ventricular fractional shortening and survival rates.

    • Main Results:

    • Left ventricular fractional shortening decreased significantly after complete valve excision but remained stable with chordal preservation.
    • Patients undergoing chordal preservation demonstrated a survival benefit at 5 years (92% vs. 80%, p=0.001).
    • Preservation of the posterior leaflet alone yielded results comparable to total chordal preservation.

    Conclusions:

    • Chordal preservation during mitral valve replacement improves survival and functional status.
    • This technique preserves left ventricular geometry and function, enhancing overall cardiac performance.
    • Posterior leaflet preservation offers excellent outcomes, suggesting less extensive chordal preservation may be sufficient.