Key result
A wide bioprosthetic interstrut distance subtending the retained anterior mitral leaflet was associated with a greater requirement for inotropic stress to precipitate LVOTO.
Why the study?
The anterior mitral leaflet contributes to LV function but is usually excised during bioprosthetic valve insertion; methods to safely retain it are needed.
Does a wide interstrut distance subtending the preserved anterior mitral leaflet mitigate left ventricular outflow tract obstruction during bioprosthetic mitral valve replacement?
Does a wide interstrut distance subtending the preserved anterior mitral leaflet mitigate left ventricular outflow tract obstruction during bioprosthetic mitral valve replacement?
In a sheep model, a wide bioprosthetic interstrut distance subtending a preserved anterior mitral leaflet mitigates the severity and precipitability of left ventricular outflow tract obstruction.
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Retaining AML at MVR caused LVOTO in 13/15 sheep insertions; leaves open whether modified techniques enable safe AML preservation in patients.
Brunel et al. (2021) studied Left ventricular outflow tract obstruction following mitral valve replacement (n=5). Wide interstrut distance subtending the anterior mitral leaflet vs. Narrow interstrut distance subtending the anterior mitral leaflet was evaluated on Left ventricular outflow tract obstruction (LVOTO) caused by systolic anterior motion (SAM). A wide bioprosthetic interstrut distance subtending the retained anterior mitral leaflet was associated with a greater requirement for inotropic stress to precipitate LVOTO.
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