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Bileaflet versus posterior-leaflet-only preservation in mitral valve replacement
Ahmet Coskun Ozdemir1, Bilgin Emrecan1, Ahmet Baltalarli1
1Department of Cardiac and Vascular Surgery (Drs. Baltalarli and Ozdemir), Ozel Denizli Cerrahi Hospital, 20020 Denizli; and Department of Cardiac and Vascular Surgery (Dr. Emrecan), Pamukkale University, 20070 Denizli; Turkey.
Texas Heart Institute Journal
|May 9, 2014
Summary
Complete preservation of mitral valve leaflets (MVR-B) prevented a decrease in left ventricular ejection fraction post-surgery compared to preserving only the posterior leaflet (MVR-P). Bileaflet preservation is recommended for patients with impaired left ventricular function.
Area of Science:
- Cardiac Surgery
- Cardiovascular Research
- Surgical Techniques
Background:
- Mitral valve replacement (MVR) is a common cardiac procedure.
- Preservation of the subvalvular apparatus during MVR is debated.
- The impact of preserving both leaflets versus only the posterior leaflet requires further investigation.
Purpose of the Study:
- To compare the outcomes of mitral valve replacement with complete leaflet preservation (MVR-B) versus posterior leaflet preservation alone (MVR-P).
- To evaluate the effects on left ventricular function and other clinical parameters.
Main Methods:
- Retrospective analysis of 70 patients undergoing mitral valve replacement.
- Patients divided into MVR-B (n=16) and MVR-P (n=54) groups.
- Preoperative and postoperative clinical and echocardiographic data were assessed.
Main Results:
- No significant difference in left ventricular outflow tract obstruction between groups.
- MVR-B showed no postoperative decrease in left ventricular ejection fraction, unlike MVR-P (P=0.003).
- No differences observed in need for inotropic support, ICU/hospital stay, atrial fibrillation, or mortality.
Conclusions:
- Bileaflet preservation effectively prevents the decline in left ventricular ejection fraction post-MVR.
- Posterior leaflet preservation alone resulted in a decreased left ventricular diameter.
- Bileaflet preservation is the preferred method for patients with compromised left ventricular function to maintain ejection fraction and reduce mortality.
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