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Mitral valve sub valvular apparatus preservation in pure or predominant rheumatic mitral stenosis
Journal of Cardiothoracic Surgery volume 10, Article number: A2 (2015)
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 significant number of studies on the subject.
The majority of these studies have demonstrated the value of subvalvular apparatus preservation on the future of ventricular function in the immediate and distant; however almost all of these studies have concerned patients with mitral insufficiency lesions.
Aims/Objectives
Our aim is to evaluate the impact of mitral valve subvalvular apparatus preservation on left ventricular function after valve replacement in patient with predominant or pure mitral stenosis
Method
77 patients underwent a mitral valve replacement for mitral valve stenosis, 54 patients (group1) had no preservation, 23 patients (group 2) had partial sub valvular preservation; there were no significant differences between the two groups in pre-operative parameters (age, sex, functional status, AF, LVEDD, LVESD, LVEF).
The mean follow up was 19 months.
Results
In all of the postoperative study parameters, no significant difference was found between groups either in terms of mortality, left or right ventricular function, LVEF (62.98 +/- 2.65% vs 61 +/- 4.20 %); LVEDD (47.3 +/- 1.4 mm vs 46.1 +/- 2.6 mm); LVESD (30.8 +/- 1.7 mm vs 30.9 +/- 2.6 mm); TAPSE (15.78 +/- 0.88 mm vs 15.65 +/- 1.0 mm), Sa (10.58 +/- 0.47 cm/s vs 10.35 +/- 0.77 cm/s) respectively for group 1 and group 2.
Discussion/Conclusion
The short- and medium-term results of our study did not demonstrate the interest of preserving the sub valvular apparatus in mitral valve replacement surgery on pure or predominant rheumatic mitral stenosis; however a longer follow-up is need to evaluate the impact on either left or right ventricular function.
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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Bouzid, A., Chibane, S., Atbi, M. et al. Mitral valve sub valvular apparatus preservation in pure or predominant rheumatic mitral stenosis. J Cardiothorac Surg 10 (Suppl 1), A2 (2015). https://doi.org/10.1186/1749-8090-10-S1-A2
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DOI: https://doi.org/10.1186/1749-8090-10-S1-A2
Keywords
- Mitral Valve
- Ventricular Function
- Valve Replacement
- Left Ventricular Function
- Mitral Stenosis