Abstract
BackgroundMitral 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.MethodsClinical 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.ResultsNo 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.ConclusionsThe 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.
Highlights
Mitral valve replacement with the total leaflet preservation technique can yield good results; its development is limited by patient-valve mismatch
The patients were divided into three groups: group A included 62 patients treated with the modified total leaflet preservation technique; group B included 80 patients treated with the posterior leaflet preservation technique; and group C included 38 patients treated with the no leaflet preservation technique
Preoperative information There were no significant differences in the sex ratio, age, body surface area, major diagnosis, preoperative cardiac function (NYHA), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD), or left ventricular ejection fraction (LVEF) between the three groups
Summary
Mitral valve replacement with the total leaflet preservation technique can yield good results; its development is limited by patient-valve mismatch. We compared the efficacies of the modified total leaflet preservation technique, posterior leaflet preservation technique, and no leaflet preservation technique in mitral valve replacement. Mitral valve replacement (MVR)—an important treatment for rheumatic mitral valve disease—has been widely promoted and rapidly developed worldwide. In 1964, Lillehei et al found that the mortality and complications were lower, and the cardiac function was better if some part of the mitral valve. Guo et al Journal of Cardiothoracic Surgery (2019) 14:102
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