MITRAL-VALVE REPLACEMENT WITH PRESERVATION OF THE SUBVALVULAR STRUCTURES WHERE POSSIBLE - AN ECHOCARDIOGRAPHIC AND CLINICAL COMPARISON WITHCASES WHERE PRESERVATION WAS NOT POSSIBLE - SURGICAL TECHNIQUE AND EARLY POSTOPERATIVE COURSE

Mitral valve replacement (MVR) is still associated with a relatively h igh mortality. To proove the benefits of chordal preservation at mitra l valve replacement, we investigated its effects in a series of 65 con secutive MVR patients. Of those patients, in 42 preservation of the mi tral subvalvular structures was possible whereas in the other 23 they had to be excised. Both groups showed no differences in age, sex, preo perative NYHA class, and valve pathology. Intra- and postoperative man agement was similar in both groups. The surgical techniques employed a re described and the early postoperative course of both groups are ana lysed. Clinical, electrocardiographic and echocardiographic investigat ions, measuring left-atrial and -ventricular diameters, right-ventricu lar diameters and left-ventricular length, demonstrated that whereas b eneficial effects were evident in both groups, the amount of benefits was higher in patients with chordal preservation. Chordal preservation also provided less arrhythmias than chordal resection.