[Modified mitral valve replacement with preservation of chordae tendinae]

The purpose of leaving the mitral apparatus in place during mitral valve replacement is twofold. One is to preserve ventricular performance and another is to prevent ventricular rupture. Our clinical results of modified mitral valve replacement were compared with those of conventional mitral valve replacement. The analysis was done to see if any difference existed between patients predominantly with mitral stenosis and with regurgitation. Hospital mortality of the modified group was significantly less than that of the conventional group. In mitral stenosis, this was due to the disappearance of ventricular rupture. In mitral regurgitation, on the other hand, this was mostly due to the decrease of low output-multi-organ failure syndrome. Ventricular function was assessed by echocardiography up to 3 years postoperatively. The superiority of ventricular performance in modified technique was prominent in the subgroup of mitral regurgitation.