The impact of sub-valvular apparatus preservation on prosthetic valve dysfunction during mitral valve replacement :Alireza Alizadeh-Ghavidel, Yalda Mirmesdagh, Mehrzad Sharifi, Anita Sadeghpour, Reza Nakhaeizadeh, Gholamreza Omrani, Research in Cardiovascular Medicine

ORIGINAL ARTICLE
Year : 2013 | Volume : 2 | Issue : 1 | Page : 55--61

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

Alireza Alizadeh-Ghavidel¹, Yalda Mirmesdagh¹, Mehrzad Sharifi¹, Anita Sadeghpour², Reza Nakhaeizadeh¹, Gholamreza Omrani¹
¹ Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center; Tehran University of Medical Sciences, Tehran, IR Iran
² Echocardiograghy Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, IR Iran

Correspondence Address:
Yalda Mirmesdagh
Rajaie Cardiovascular Medical and Research Center, Rajaie Cardiovascular Medical and Research Center, Vali-Asr Ave, Niayesh Blvd, Tehran
IR Iran

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 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. 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). 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.

How to cite this article:
Alizadeh-Ghavidel A, Mirmesdagh Y, Sharifi M, Sadeghpour A, Nakhaeizadeh R, Omrani G. The impact of sub-valvular apparatus preservation on prosthetic valve dysfunction during mitral valve replacement.Res Cardiovasc Med 2013;2:55-61

How to cite this URL:
Alizadeh-Ghavidel A, Mirmesdagh Y, Sharifi M, Sadeghpour A, Nakhaeizadeh R, Omrani G. The impact of sub-valvular apparatus preservation on prosthetic valve dysfunction during mitral valve replacement. Res Cardiovasc Med [serial online] 2013 [cited 2022 Jul 3 ];2:55-61
Available from: https://www.rcvmonline.com/article.asp?issn=2251-9572;year=2013;volume=2;issue=1;spage=55;epage=61;aulast=Alizadeh-Ghavidel;type=0