Mitral Para-valvular leakage following usage of non-pledgeted compared to Teflon-pledgeted sutures

Abstract

Background: Despite a wide variety of mitral prosthesis suturing, pledgeted annular sutures are preferred to lower the incidence of para-valvular leakage (PVL). However, there is limited evidence in the literature on the effect of non-plegeted sutures on such serious complication. Objective: The purpose of this study was to determine the safety and practicality of employing non-pledgeted sutures for Mitral valve replacement (MVR), especially regarding postoperative PVL. Patients and methods: Data on 100 patients with MVR were gathered from Cairo University Hospitals. Cases were split into two groups: group 1 underwent surgery using non-pledgeted horizontal sutures where in group 2 we used Teflon-pledgeted sutures. Preoperative, operative, and postoperative factors including follow-up echocardiographic examination one year following discharge, were compared between the two groups. Results: Both groups had similar preoperative characteristics, with group 1 including 49 patients compared to 51 patients in group 2. Data showed significantly shorter cross clamping (AXC) time in group 1 (p value < 0.05), intraoperative TEE has never observed para-prosthetic leakage in both groups, there was no significant difference regarding both mean ICU and hospital stay.