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Left ventricular function after mitral valve surgery

T E David1, S Armstrong, Z Sun

  • 1Division of Cardiovascular Surgery, Toronto Hospital, Ontario, Canada.

The Journal of Heart Valve Disease
|October 1, 1995
PubMed
Summary
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Mitral valve repair is preferred for degenerative mitral regurgitation. If replacement is needed, preserving chordae tendineae improves long-term left ventricular function and survival rates.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Disease
  • Medical Technology

Background:

  • Degenerative mitral regurgitation necessitates surgical intervention.
  • Various operative procedures exist, each with potential impacts on cardiac function and survival.
  • Optimizing surgical techniques is crucial for improving patient outcomes.

Purpose of the Study:

  • To compare the efficacy of different mitral valve operative procedures.
  • To evaluate the impact of annuloplasty ring type on early and long-term left ventricular function.
  • To assess the long-term survival and functional benefits of preserving chordae tendineae during mitral valve replacement.

Main Methods:

  • Randomized clinical trial comparing flexible versus rigid annuloplasty rings.

Related Experiment Videos

  • Long-term follow-up of patients undergoing mitral valve repair.
  • Randomized trial comparing mitral valve replacement with and without chordae tendineae preservation.
  • Logistic regression analysis to identify predictors of late mortality.

    • Main Results:

    • Flexible annuloplasty rings showed better early postoperative left ventricular systolic function compared to rigid rings, with no significant difference at two years.
    • Mitral valve repair demonstrated a 10-year actuarial survival of 86% +/- 6%.
    • Mitral valve replacement with chordae tendineae preservation resulted in lasting benefits in left ventricular function, exercise capacity, and a 10-year actuarial survival of 80% +/- 6%, compared to 63% +/- 6% without preservation.

    Conclusions:

    • Mitral valve repair should be prioritized when feasible.
    • Preservation of chordae tendineae during mitral valve replacement offers significant long-term advantages.
    • Age >65 and complete mitral valve excision are predictors of late mortality.