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[Mitral valve replacement by mechanical disk valve. A surgical alternative]

J A Santibáñez Salgado1, S Celaya Lara, M S Urrea Ramos

  • 1Departamento de Cirugía Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan, México, D.F.

Archivos Del Instituto De Cardiologia De Mexico
|March 1, 1994
PubMed
Summary

This study shows that mitral valve replacement using a mechanical disc valve and running suture is safe and effective. Preserving the posterior mitral apparatus reduces ischemic and bypass times, preventing complications.

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Mitral valve replacement is a critical cardiac procedure.
  • Preserving native valve structures can potentially improve outcomes.
  • Mechanical disc valves offer durability but may have specific implantation challenges.

Purpose of the Study:

  • To evaluate the safety and efficacy of mitral valve replacement using a mechanical disc valve with a running suture technique.
  • To assess the impact of preserving the posterior mitral valve apparatus on surgical outcomes.
  • To investigate the potential benefits of this technique in reducing operative times and preventing valve dysfunction.

Main Methods:

  • Retrospective analysis of 10 patients undergoing mitral valve replacement between July and December 1993.
  • Utilized a mechanical disc valve with a running suture technique, preserving the posterior mitral valve apparatus.

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  • Employed cardiopulmonary bypass with moderate hypothermia (28°C) and cold potassium cardioplegia for cardiac protection.

    • Main Results:

    • Mean patient age was 44.2 years, with varying New York Heart Association (NYHA) functional classes (II, III, IV).
    • Surgical procedures included simple mitral valve replacement, double valve replacement, and myocardial revascularization.
    • For simple mitral valve replacement, mean aortic cross-clamping time was 37 minutes and cardiopulmonary bypass time was 64 minutes.

    Conclusions:

    • The described surgical alternative for mitral valve replacement is effective and safe.
    • Preserving the posterior mitral apparatus may lead to reduced ischemic and cardiopulmonary bypass times.
    • This technique potentially avoids mechanical disc jamming caused by residual leaflet or tendinous chordae.