This prospective study was carried out to compare between the effects
of mitral valve repair. mitral valve replacement (MVR) with and without
preservation of valve leaflet (s) and chorciae tendtrteae on left ventricular
(LV ) function.
Sixty patients with chronic nand regurge (MR) of rheumatic origin
were classified into three groups. Group A : 20 patients who had undergone
mitral valve repair with fixed Carpentier's ring. Group 8:20 patients
who had undergone chordae preserving MVR. Group C: 20 patients who
had undergone chordae-removing MVR. All available preoperative, operative
and postoperative data were compared. LV peribrmance was evaluated
using both transthoracic CITE) and multiplane transesophageal echocardiography
(TEE) 2 weeks and 3 months postoperatively.
The results of the present study showed that preservation of the mitral
valve (MW apparatus during mitral valve repair (group A) and MVR (group
B) for chronic MR helped to preserve LV function (ejection fraction EF ) in
the early post operative period (2 weeks: 61.2+3.4 in group A. 58.1+3.4 in
group B and 51.9+4.1 in group C) and late post operatively (3 months:
66.8+3.4 in group A, 62+2.9 in group B and 49.8+4.6 in group C). Patients
of group A and B were easily weaned off cardiopulmonary bypass
and had significantly shorter stay in the ICU. also their need for vasoac-
.
five drugs were less than those of group C. The new multiplane TEE resolved
many problems that were a true bother in FIE e.g. poor ech.ogenici-ty |
