Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation...

Mitral valve replacement with the total leaflet preservation technique can yield good results; however, its development is limited by patient-valve mismatch. Therefore, we compared the efficacies of the modified total leaflet preservation technique, posterior leaflet preservation technique, and no leaflet preservation technique in mitral valve replacement.

Clinical records and echocardiographic data of 180 patients who underwent mitral valve replacement for rheumatic mitral valve disease between 2009 and 2017 were analysed retrospectively to summarise the operative experience and short-term (six months) results. The patients were divided into three groups: group A (n = 62), treated with the modified total leaflet preservation technique; group B (n = 80), treated with the posterior leaflet preservation technique; and group C (n = 38), treated with the no leaflet preservation technique.

No significant difference in the preoperative clinical data was noted between the groups (p > 0.05). The clamp and recovery times of group A were longer (p < 0.05) and shorter (p < 0.05), respectively, than those of groups B and C. The postoperative left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular ejection fraction of group A were significantly better than those of groups B and C. The incidence of low cardiac output syndrome in group A was lower than that in group C (p < 0.05). There was no postoperative left ventricular posterior wall rupture or mechanical valve dysfunction in group A.

The short-term results of the modified total leaflet preservation technique were better than those of the other techniques. This technique is also suitable for patients with rheumatic mitral valve stenosis.