the impact of sub-valvular apparatus preservation on prosthetic valve dysfunction during mitral valve replacement

نویسندگان

alireza alizadeh-ghavidel heart valve disease research center, rajaie cardiovascular medical and research center; tehran university of medical sciences, tehran, ir iran

yalda mirmesdagh heart valve disease research center, rajaie cardiovascular medical and research center; tehran university of medical sciences, tehran, ir iran; rajaie cardiovascular medical and research center, rajaie cardiovascular medical and research center, vali-asr ave, niayesh blvd, tehran, ir iran. tel: +98-2123923061, fax: +98-2122663209

mehrzad sharifi heart valve disease research center, rajaie cardiovascular medical and research center; tehran university of medical sciences, tehran, ir iran

anita sadeghpour echocardiograghy research center, rajaie cardiovascular medical and research center, tehran university of medical sciences, tehran, ir iran

چکیده

conclusions preservation of mitral annulus and papillary muscle continuity may enhance post- mvr cardiac performance with low mortality and morbidity rates. the risk of pvd was not significantly higher than conventional mvr in our series. results the improvement of functional status was seen in almost all survivors but was more obvious in the group i. in early follow-up, 56.4% of group i cases and 44.1% of group ii patients were classified as new york heart association class i. these rates were 84.2% and 71.2% in mid-term follow-up, respectively (p < 0.001). mortality rate was significantly lower in the group i (2.6%) compared to the group ii (8.9%) (p = 0.03). there was a trend for higher frequency of postoperative atrial fibrillation in the group ii compared to that in the group i (52.7% vs. 38.5%, p = 0.12).the incidence of prosthetic valve dysfunction (pvd) was 5.1% in the group i and 4.5% in the group ii, but this difference was not statistically significant (p = 0.56). materials and methods this retrospective study included 151 patients with the mean age of 46 years who underwent mvr (female/male = 93/58). in the group i consisting of 39 patients, mvr with chordae preservation was performed (bi-leaflet preservation = 20; posterior leaflet preservation = 19). in the group ii consisting of 112 patients, sub-valvular apparatus was resected completely during mvr. preoperative patients’ characteristics, including age, sex, functional status, left ventricular ejection fraction, and end-diastolic or end-systolic dimensions were statistically similar in both groups. mean follow-up period was 60.3 ± 26 months. background sub-valvular apparatus preservation (sap) during mitral valve replacement (mvr) is not a new concept. some surgeons prefer to excise the apparatus. objectives the aim of this study was to reduce the risk of prosthetic valve dysfunction.

برای دانلود باید عضویت طلایی داشته باشید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

The Impact of Sub-valvular Apparatus Preservation on Prosthetic Valve Dysfunction During Mitral Valve Replacement

BACKGROUND Sub-valvular apparatus preservation (SAP) during mitral valve replacement (MVR) is not a new concept. Some surgeons prefer to excise the apparatus. OBJECTIVES The aim of this study was to reduce the risk of prosthetic valve dysfunction. MATERIALS AND METHODS This retrospective study included 151 patients with the mean age of 46 years who underwent MVR (Female/male = 93/58). In th...

متن کامل

Mitral valve sub valvular apparatus preservation in pure or predominant rheumatic mitral stenosis

Background/Introduction Surgery of the mitral valve is an important part of the surgical activity at Algerian heart surgery departments. In many cases the lesions exceed the possibility of native valve preservation, thus requiring the replacement thereof. When replacing, conservation of the subvalvular apparatus or not remains a question which had a real interest, which was reflected in the sig...

متن کامل

Preservation versus non-preservation of mitral valve apparatus during mitral valve replacement: a meta-analysis of 3835 patients.

Resection of the chordopapillary apparatus during mitral valve replacement has been associated with a negative impact on survival. Mitral valve replacement with the preservation of the mitral valve apparatus has been associated with better outcomes, but surgeons remain refractory to its use. To determine if there is any real difference in preservation vs non-preservation of mitral valve apparat...

متن کامل

Mitral valve replacement with the preservation of the entire valve apparatus.

OBJECTIVE The papillary muscles and the chordae tendineae of both mitral leaflets contribute to the preservation of the left ventricular function. Most surgeons, however, routinely excise the anterior mitral leaflet. METHODS In a group of nine patients, six of them underwent mitral valve replacement alone and three underwent both aortic and mitral valve replacements, all the mitral apparatus ...

متن کامل

Complete versus partial preservation of mitral valve apparatus during mitral valve replacement: meta-analysis and meta-regression of 1535 patients.

OBJECTIVES To determine if there is any real difference between complete preservation (CP) and partial preservation (PP) of the mitral valve apparatus during mitral valve replacement (MVR) in terms of hard outcomes. METHODS MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that compared outcomes [30-day mo...

متن کامل

منابع من

با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید


عنوان ژورنال:
research in cardiovascular medicine

جلد ۲، شماره ۱، صفحات ۵۵-۶۱

کلمات کلیدی

میزبانی شده توسط پلتفرم ابری doprax.com

copyright © 2015-2023