MITRAL-VALVE PROSTHETIC IMPLANTATION WITH PRESERVATION OF NATIVE MITRAL-VALVE APPARATUS

To avoid postoperative morbidity and mortality often associated with l eft ventricular dysfunction after mitral valve replacement (MVR) for c hronic mitral insufficiency, reconstruction or preservation of the nat ive mitral valve apparatus may be attempted during mitral prosthetic i mplantation (MPI). The effects of mitral surgery on heart function, st udied with echocardiography and radionuclide angiography, were compare d in seven patients with MPI (study group) and five with MVR (control group) who underwent complete preoperative, early postoperative and 3- 6 months follow-up examinations. Preoperatively there was significant intergroup difference only in right ventricular ejection fraction meas ured at radionuclide angiography, which was lower in the MPI group (p < 0.05). At follow-up the MPI group had improved as regards this fract ion (p < 0.005) and stroke volume index (p < 0.05). The number of pati ents with improved NYHA class at follow-up was significantly greater i n the MPI group. Our preliminary experience with preservation of the n ative mitral valve apparatus thus suggests that the method offers haem odynamic advantages for postoperative right ventricular function.