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Abstract
associated with long-term morbidity and mortality. Despite improvements
in myocardial protection and prosthetic valves, the rate of morbidity has not
decreased significantly over the years. The most common cause of death
following MVR is cardiac failure (Muthialu et al., 2005). Current evidence
suggests that mitral valve repair is superior to replacement. Preservation of the
subvalvular apparatus maintains LV function and thus improves survival (Corin
et al., 1995). Repair is not always feasible or successful, particularly with
rheumatic valve disease in young patients and severely disorganized valves. An
argument against preservation of the anterior leaflet was that only undersized
valve prosthesis could be implanted. Another argument against preservation of
the anterior leaflet is that it might cause obstruction of the LVOT.
The aim of this study is to asses the immediate and mid-term changes in
LV performance after MVR with preservation of annulopapillary continuity.
Methods: In order to obtain this target, fifty consecutive patients who
underwent MVR were studied. All our patients were suffering from rheumatic
mitral valve disease In all patients preservation of the annulopapillary continuity
were used using different techniques. The choice of the techniques depended on
the nature of the subvalvular apparatus.
Conclusion: Preservation of the annulopapillary continuity improves left
ventricular ejection fraction and result in reduction in both left ventricular
systolic and diastolic diameters. These techniques can be safely performed
without effect on the choice of the prosthetic size or fear of left ventricular
outflow tract obstruction or interference with prosthetic leaflets motion.