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Preservation of Rear Wing with a Subvalvular Structure in Mitral Prosthetics

Received: 12 September 2020    Accepted: 24 September 2020    Published: 7 October 2020
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Abstract

The goal is to evaluate the effectiveness of the immediate results (not more than 6 months) of the mitral valve prosthetics operation with preservation of the posterior valve with the chordal-papillary apparatus. Material and methods: the study included 96 patients after surgery with preservation of the posterior mitral valve cusp. The average age of the patients was 45.9±12.0 years. The inclusion criteria were the final diastolic size (CRD) of the left ventricle (LV) and ejection fraction. Results: in the immediate postoperative period was observed a decrease in the final systolic and diastolic sizes and volumes of the left ventricle. A similar dynamics was noted in relation to the size of the left atrium. The pressure gradient on the mitral prosthesis and the systolic pressure in the pulmonary artery decreased. The ejection fraction of the left ventricle in the near postoperative period increased on average 57.9±9.8 before surgery and 59.2±8.2 after surgery. According to echocardiography, there were no cases of dysfunction of the artificial heart valve or prosthesis-dependent complications due to preserved cusp tissue or chords of the posterior cusp, and there was a positive dynamics of remodeling of the left ventricle. The surgical technique of preserving the posterior valve with its chordal-papillary apparatus is simple in surgical execution and does not lengthen the time of cardiopulmonary bypass (57.3±26.1 min).

Published in Cardiology and Cardiovascular Research (Volume 4, Issue 4)
DOI 10.11648/j.ccr.20200404.12
Page(s) 175-179
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Mitral Valve Replacement, Subvalvular Structure, Posterior Leaflet, Left Ventricle

References
[1] Shumakov V. I., Semenovskiy M. L., Sokolov V. V. Mitral valve replacement with full or partial preservation of subvalvular structures. // Thoracic surgery. 1989. №.3. P. 5-9.
[2] Yilong Guо, Shuwu He, Tianguang Wang, Comparison of modified total leaflet preservation, posterior leaflet preservation, and no leaflet preservation techniques in mitral valve replacement – a retrospective study. J Cardiothorac Surg 2019; 14: 102.
[3] Goldman M. E., Mora F., Guarino T., Fuster V., Mindich BP. Mitral valvuloplasti is superior to valve replacement for preservation of left ventricular function. An intraoperative two-demontional echocardiographic study// J. Amer. Coll. 1987. V. 10. N 3. P. 568-575.
[4] Lillechei C. W., Levy M. J. Mitral valve replacement with preservation of papillary muscles and chordae tendinea // J. Thorac. Cardiovasc. Surg. 1964. Vol. 47, N 4. P. 532-543.
[5] Toktosunova D. B., Djundubaev M. K., Seytahunova E. D., Ahmedova I. A. Remodeling of the left heart in patients with rheumatic mitral valve disease after mitral valve replacement with preservation of subvalvular structures // J. Scientific Research Institute of Heart Surg. and Organ Transplantation. 2020. 4. 40-44.
[6] Shevchenko Y. L., Popov L. V. Volkova L. V. 20-years’ experience of MVR with full or partial preservation of valve structures. // Bulletin of NCCVS named. А. N. Bakulev RAMS. 2006. Т. 7, №3. P. 41.
[7] Sintek C. F., Khonsari S. Use of extended polythetrafluoroethylene (ePTFE) chordae to re-establish annular-papillary connection after mitral valve excision // J. Heart Valve Dis. 1996. Vol. 5. P. 362-364.
[8] Ivanov V. A. Popov S. O., Kashin V. Y., Konstantinov B. A. Subvalvular structures preservation at mitral valve replacement. //Surgery Journal named. N. I. Pirogov. 2007. №7. P. 36-40.
[9] Chen L., Chen B., Hao J., Wang X., Ma R., Cheng W., Qin C., Xiao Y. Complete preservation of the mitral valve apparatus during mitral valve replacement for rheumatic mitral regurgitation in patients with an enlarged left ventricular chamber //Heart Surg. Forum. 2013. V. 16. N3. P. 137-43.
[10] Dobrotin S. S. Surgical treatment of mitral stenosis and its complicated forms. / Dobrotin S. S., Gamzaev A. B., Chiginev V. A. Lashmanov D. I. //Thoracic and Cardiovascular surgery. 2005. - № 3. - P. 15—19.
[11] Athanasiou T., Chow A., Rao C., Aziz O., Siannis F., Ali A., Darzi A., Wells F. Preservation of the mitral apparatus: evidence synthesis and critical reappraisal of surgical techniques //Eur. J. Cardiotorac Surg. 2008. V. 33. N3. P. 391-401.
[12] Casquero E., Asorey V., Lugo J., Pradas G. Ruptured papillary muscle after mitral valve replacement with preservation of subvalvular structures //J. Cardiol. Surg. 2010. V. 25. N 6. P. 694-695.
[13] Coutinho GF, Bihun V, Correia PE, Antunes PE, Antunes MJ. Preservation of the subvalvular apparatus during mitral valve replacement of rheumatic valves does not affect long-term survival. //Eur J, Cardiothorac, Surg. 2015. V. 48. N6. P. 861-7.
[14] Lafci G., Cagli K., Cicek O. F., Korkmaz K., Turak O., Uzun A., Yalcinkaya A., Diken A., Gunertem E. Papilary muscle repositioning as a subvalvular apparatus preservation technique in mitral stenosis patients with normal left ventricular systolic function //Tex Heart Inst J. 2014. V. 41. N1. P. 33-39.
[15] Timala RB, Joshi D, Aryal M, Bhandari K, Singh Y, Sharma J. Effects of subvalvular apparatus preservation in mitral valve replacement among rheumatic patients: early and mid-term follow up. J Inst Med 2016, 38: 2-3.
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  • APA Style

    Zhumabaev Sultanmurat Abdiraimovich, Asanaliev Mirlan Isaevich, Urmanbetov Kubatbek Samyybekovich, Tursunbekova Gulnaz Tursunbekovna. (2020). Preservation of Rear Wing with a Subvalvular Structure in Mitral Prosthetics. Cardiology and Cardiovascular Research, 4(4), 175-179. https://doi.org/10.11648/j.ccr.20200404.12

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    ACS Style

    Zhumabaev Sultanmurat Abdiraimovich; Asanaliev Mirlan Isaevich; Urmanbetov Kubatbek Samyybekovich; Tursunbekova Gulnaz Tursunbekovna. Preservation of Rear Wing with a Subvalvular Structure in Mitral Prosthetics. Cardiol. Cardiovasc. Res. 2020, 4(4), 175-179. doi: 10.11648/j.ccr.20200404.12

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    AMA Style

    Zhumabaev Sultanmurat Abdiraimovich, Asanaliev Mirlan Isaevich, Urmanbetov Kubatbek Samyybekovich, Tursunbekova Gulnaz Tursunbekovna. Preservation of Rear Wing with a Subvalvular Structure in Mitral Prosthetics. Cardiol Cardiovasc Res. 2020;4(4):175-179. doi: 10.11648/j.ccr.20200404.12

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  • @article{10.11648/j.ccr.20200404.12,
      author = {Zhumabaev Sultanmurat Abdiraimovich and Asanaliev Mirlan Isaevich and Urmanbetov Kubatbek Samyybekovich and Tursunbekova Gulnaz Tursunbekovna},
      title = {Preservation of Rear Wing with a Subvalvular Structure in Mitral Prosthetics},
      journal = {Cardiology and Cardiovascular Research},
      volume = {4},
      number = {4},
      pages = {175-179},
      doi = {10.11648/j.ccr.20200404.12},
      url = {https://doi.org/10.11648/j.ccr.20200404.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200404.12},
      abstract = {The goal is to evaluate the effectiveness of the immediate results (not more than 6 months) of the mitral valve prosthetics operation with preservation of the posterior valve with the chordal-papillary apparatus. Material and methods: the study included 96 patients after surgery with preservation of the posterior mitral valve cusp. The average age of the patients was 45.9±12.0 years. The inclusion criteria were the final diastolic size (CRD) of the left ventricle (LV) and ejection fraction. Results: in the immediate postoperative period was observed a decrease in the final systolic and diastolic sizes and volumes of the left ventricle. A similar dynamics was noted in relation to the size of the left atrium. The pressure gradient on the mitral prosthesis and the systolic pressure in the pulmonary artery decreased. The ejection fraction of the left ventricle in the near postoperative period increased on average 57.9±9.8 before surgery and 59.2±8.2 after surgery. According to echocardiography, there were no cases of dysfunction of the artificial heart valve or prosthesis-dependent complications due to preserved cusp tissue or chords of the posterior cusp, and there was a positive dynamics of remodeling of the left ventricle. The surgical technique of preserving the posterior valve with its chordal-papillary apparatus is simple in surgical execution and does not lengthen the time of cardiopulmonary bypass (57.3±26.1 min).},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Preservation of Rear Wing with a Subvalvular Structure in Mitral Prosthetics
    AU  - Zhumabaev Sultanmurat Abdiraimovich
    AU  - Asanaliev Mirlan Isaevich
    AU  - Urmanbetov Kubatbek Samyybekovich
    AU  - Tursunbekova Gulnaz Tursunbekovna
    Y1  - 2020/10/07
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ccr.20200404.12
    DO  - 10.11648/j.ccr.20200404.12
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 175
    EP  - 179
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20200404.12
    AB  - The goal is to evaluate the effectiveness of the immediate results (not more than 6 months) of the mitral valve prosthetics operation with preservation of the posterior valve with the chordal-papillary apparatus. Material and methods: the study included 96 patients after surgery with preservation of the posterior mitral valve cusp. The average age of the patients was 45.9±12.0 years. The inclusion criteria were the final diastolic size (CRD) of the left ventricle (LV) and ejection fraction. Results: in the immediate postoperative period was observed a decrease in the final systolic and diastolic sizes and volumes of the left ventricle. A similar dynamics was noted in relation to the size of the left atrium. The pressure gradient on the mitral prosthesis and the systolic pressure in the pulmonary artery decreased. The ejection fraction of the left ventricle in the near postoperative period increased on average 57.9±9.8 before surgery and 59.2±8.2 after surgery. According to echocardiography, there were no cases of dysfunction of the artificial heart valve or prosthesis-dependent complications due to preserved cusp tissue or chords of the posterior cusp, and there was a positive dynamics of remodeling of the left ventricle. The surgical technique of preserving the posterior valve with its chordal-papillary apparatus is simple in surgical execution and does not lengthen the time of cardiopulmonary bypass (57.3±26.1 min).
    VL  - 4
    IS  - 4
    ER  - 

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Author Information
  • Research Institute of Cardiovascular Surgery and Organ Transplantation of the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan

  • Research Institute of Cardiovascular Surgery and Organ Transplantation of the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan

  • Research Institute of Cardiovascular Surgery and Organ Transplantation of the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan

  • Research Institute of Cardiovascular Surgery and Organ Transplantation of the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan

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