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Abstract
The beneficial effect of chordal preservation on LV function after MVR for chronicmitral regurge had been proven.
The aim of this study is to evaluate whether total chordal preservation achieves additional benefit over posterior chordal preservation.
Preoperatively, the two groups were comparable as regard clinical diagnosis, age, sex, body surface area and cchocardicgraphic data. Surgical technique of total .chordal
preservation in Group I demands relatively longer bypass time and aortic cross clamp time. However the need for inotropic support, and lCU stay were significantly lower.
There were no perioperatve mortalities among the two groups.
Post operatively, all patients were clinically improved as evidenced by NYHA
functional classing. Echocardiographic data showed a decline in L VEDD, L VESD& LAD in both groups. By analysis of Valiance, the decline in these dimensions was significantly more in patients in Group 1.
L VEF &LVFS were used as measures of LV function in this study. EF declines in
both groups, however, the decline was more pronounced in patients in Group II.
Total chordal preservation was not associated with interference with the movements of mechanical leaflets, or L VOT obstruction.
sizes of inserted prosthetic valves were
relatively smaller in Group I, but were adequate for the patients body surface area.
Whenever repair is not possible, MVR with total chordal preservation IS
recorrunended. It has the advantages of being technically feasible, without procedure - related - complications, shorter ICU and hospital stay and better preservation of LV function.