&lt;![CDATA[&lt;B&gt;New technical approach for crossed papillopexy in mitral valve replacement surgery&lt;/B&gt;: &lt;B&gt;short term results&lt;/B&gt;]]&gt;

Gomes, Otoni Moreira; Gomes, Eros Silva; Filho, Geraldo Paulino Santana; Pontes, Jos� C. D. V.; Benfati, Ricardo A.

doi:10.1590/s1678-97412005000300018

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…After Lillehei et al reported good results with the posterior leaflet preservation technique in 1964 [1], subsequent studies demonstrated that the anterior leaflet and subvalvular tissue are equally important in protecting the left ventricular function when compared to the posterior leaflet [7, 8]. Gomes conducted a study of both leaflet preservation techniques [9]. However, LVOTS is a serious complication that has restricted the development of the total leaflet preservation technique.…”

Section: Discussionmentioning

confidence: 99%

“…The chordae tendineae and papillary muscles were kept in a suitable tension. This was beneficial not only for preserving the integrity of the mitral valve but also for protecting left ventricular function [9, 12]. Two, the preserved tissue must be placed between the mechanical valve and the original annulus to reduce its effects on the mechanical valve [3].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation techniques in mitral valve replacement – a retrospective study

Guo

Wang

et al. 2019

J Cardiothorac Surg

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Background Mitral valve replacement with the total leaflet preservation technique can yield good results; however, its development is limited by patient-valve mismatch. Therefore, we compared the efficacies of the modified total leaflet preservation technique, posterior leaflet preservation technique, and no leaflet preservation technique in mitral valve replacement. Methods Clinical records and echocardiographic data of 180 patients who underwent mitral valve replacement for rheumatic mitral valve disease between 2009 and 2017 were analysed retrospectively to summarise the operative experience and short-term (six months) results. The patients were divided into three groups: group A ( n = 62), treated with the modified total leaflet preservation technique; group B ( n = 80), treated with the posterior leaflet preservation technique; and group C ( n = 38), treated with the no leaflet preservation technique. Results No significant difference in the preoperative clinical data was noted between the groups ( p > 0.05). The clamp and recovery times of group A were longer ( p < 0.05) and shorter ( p < 0.05), respectively, than those of groups B and C. The postoperative left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular ejection fraction of group A were significantly better than those of groups B and C. The incidence of low cardiac output syndrome in group A was lower than that in group C ( p < 0.05). There was no postoperative left ventricular posterior wall rupture or mechanical valve dysfunction in group A. Conclusions The short-term results of the modified total leaflet preservation technique were better than those of the other techniques. This technique is also suitable for patients with rheumatic mitral valve stenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation techniques in mitral valve replacement – a retrospective study

Guo

Wang

et al. 2019

J Cardiothorac Surg

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“…The crossed papillopexy technique in mitral valve replacement also seeks to preserve mitral valve apparatus and thereby preserves left ventricular function. On follow up it was found to lead to improvement of ventricular remodeling [12].…”

Section: Discussionmentioning

confidence: 94%

Mitral valve replacement with the preservation of the entire valve apparatus

Alsaddique¹

2007

Rev Bras Cir Cardiovasc

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Substituição da valva mitral com preservação do aparato completo da valvaMitral valve replacement with the preservation of the entire valve apparatus Abstract Objective: The papillary muscles and the chordae tendineae of both mitral leaflets contribute to the preservation of the left ventricular function. Most surgeons, however, routinely excise the anterior mitral leaflet.Methods: In a group of nine patients, six of them underwent mitral valve replacement alone and three underwent both aortic and mitral valve replacements, all the mitral apparatus was preserved. All of these patients had mechanical valves using CarboMedics cardiac prosthesis (CarboMedics, Inc. Austin, Texas).Results: There was no mortality. Postoperative echocardiographic assessment revealed maintained left ventricular function with no interference with the prosthetic leaflet mobility and no left ventricular outflow tract gradient.Conclusion: We believe that in most patients with longstanding mitral valve regurgitation, thinned out papillary muscles and elongated chordae tendineae that are not amenable to repair, valve replacement with the preservation of the entire native valve is possible and should be encouraged. This is especially valuable for those with depressed left ventricular function, who might otherwise suffer from left ventricular dysfunction in the long-term if the entire mitral valve apparatus were to be excised.Descriptors: Mitral valve, surgery. Mitral valve insufficiency, surgery. Heart valve prosthesis implantation, methods. 219ALSADDIQUE, AA -Mitral valve replacement with the preservation of the entire valve apparatus Braz J Cardiovasc Surg 2007; 22(2): 218-223

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“…But Its proven from different studies that destruction of Atrioventricular connections leads to early S716 heart failure because Left ventricle adopts spherical shape causing poor contraction & low cardiac output with high mortality 7 . Gomes adopted preservation of both leaflets preservation technique along with the sub-valvular apparatus 8 . Al Saddique reported two main drawbacks of total preservation that were left ventricle outflow obstruction due to extensive tissue and better application of technique in mitral regurgitation patients 9 .…”

Section: Introductionmentioning

confidence: 99%

EARLY MORTALITY & MORBIDITY IN MITRAL VALVE REPLACEMENT WITH TOTAL SUB-VALVULAR APPARATUS PRESERVATION, PARTIAL PRESERVATION AND NO PRESERVATION - A COMPARATIVE STUDY

Ashfaq

Nasir

Janjua

et al. 2021

PAFMJ

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Objective: To compare the early morbidity & mortality of total sub-valvular apparatus preservation technique vs partial preservation technique and no preservation technique in mitral valve replacement. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Cardiac Surgery, Armed Forces Institute of Cardiology Rawalpindi, from Jan 2017 to Dec 2018. Methodology: One hundred fifty seven patients who underwent Mitral valve replacement were included in study. These patients were divided into three groups; group “A” comprised of those patients with total subvalvular apparatus preservation (n1=46), group “B” comprised of those patients with partial sub-valvular apparatus preservation (n2=70), group “C” comprised of those patients with no sub-valvular apparatus preservation(n3=41). Results: There were no statistical difference in the pre-operative data of the patients. No statistical difference noted in cross clamp & bypass time (p>0.05). The early morbidity in terms of ICU stay, Ventilation time, Inotropic supports, post-operative bleeding, Blood transfusion, postoperative rhythm abnormality & Re-exploration were statically significant (p<0.05). The mortality rate of patients with total sub-valvular apparatus preservation was 2.17% which is significantly less than those with partial preservation (2.85%) & no preservation (9.75%). Conclusions: Mitral valve replacement with total subvalvular apparatus preservation had low postoperative morbidity & mortality in comparison with partial and no preservation techniques.

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<![CDATA[<B>New technical approach for crossed papillopexy in mitral valve replacement surgery</B>: <B>short term results</B>]]>

Cited by 5 publications

References 16 publications

Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation techniques in mitral valve replacement – a retrospective study

Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation techniques in mitral valve replacement – a retrospective study

Mitral valve replacement with the preservation of the entire valve apparatus

EARLY MORTALITY & MORBIDITY IN MITRAL VALVE REPLACEMENT WITH TOTAL SUB-VALVULAR APPARATUS PRESERVATION, PARTIAL PRESERVATION AND NO PRESERVATION - A COMPARATIVE STUDY

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