MITRAL-VALVE REPLACEMENT WITH COMPLETE RETENTION OF NATIVE LEAFLETS

Although both mitral leaflets contribute equally to the preservation o f left ventricular function after mitral valve replacement, most surge ons routinely excise the anterior mitral leaner. Possible disadvantage s of leaflet retention are left ventricular outflow tract obstruction and interference with prosthetic valve motion. In 31 patients undergoi ng mitral valve replacement, all mitral valvular and subvalvular tissu e was completely retained using a technique that involved reefing the native leaflets into the valve sutures. Fifteen Carpentier-Edwards por cine and 16 St. Jude Medical valves were implanted. Two patients died of causes unrelated to this technique. In the others, echocardiography demonstrated either no or an insignificant left ventricular outflow t ract gradient, and, in most, no valvular tissue could be seen in the l eft ventricular outflow tract. No interference with prosthetic leaflet mobility occurred. The salutary results of mitral valve replacement w ith complete leaflet retention recommend its use.