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October 25, 2022Journal of Cardiac SurgeryOpen Access

The impact of complete versus partial preservation of the sub‐valvular apparatus on left ventricular function in mitral valve replacement

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Why the study?

Although posterior leaflet preservation in MVR benefits LV function, there is a paucity of data on the impact of complete preservation of the sub-valvular apparatus.

Does complete preservation of the sub-valvular apparatus improve postoperative left ventricular function compared to partial preservation in patients undergoing mitral valve replacement?

Population

29 MVR-P and 19 MVR-C patients with complete echocardiography data

Comparison

MVR with complete sub-valvular apparatus preservation (MVR-C) vs posterior leaflet preservation (MVR-P)

Design

Retrospective cohort study

Follow-up

3-months

Authors

CLClarissa Ng Yin LingSingapore National Eye CenterFDFulya Avcı DemirAntalya Eğitim ve Araştırma HastanesiDBDavid BleetmanSt Bartholomew's Hospital

Discussion

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Member takes

Implication

May support MVR-C for LV longitudinal function; leaves open whether benefits extend to clinical outcomes in trials.

Structured PICO

Does complete preservation of the sub-valvular apparatus improve postoperative left ventricular function compared to partial preservation in patients undergoing mitral valve replacement?

P
Population
48 patients undergoing mitral valve replacement (MVR) with complete echocardiography data, median age 59 years.
I
Intervention
Mitral valve replacement with complete preservation of the sub-valvular apparatus (MVR-C)
C
Comparator
Mitral valve replacement with preservation of the posterior mitral leaflet apparatus (MVR-P)
O
Outcome
Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) at 3-months postoperativesurrogate

Complete preservation of the sub-valvular apparatus during mitral valve replacement better preserves left ventricular longitudinal function at 3 months compared to partial preservation.

Limitations

  • small patient numbers

Cite This Study

Ling et al. (2022) studied this question.

synapsesocial.com/papers/6a70ac02660549caf2c54c19https://doi.org/10.1111/jocs.17049

Topics

Mitral valve intervention
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction2014 · 1,071 citations
  2. 2Bileaflet versus Posterior-Leaflet-Only Preservation in Mitral Valve Replacement2014 · 17 citations
  3. 3Complete versus partial preservation of mitral valve apparatus during mitral valve replacement: meta-analysis and meta-regression of 1535 patients2013 · 18 citations
  4. 4Preservation of the mitral valve apparatus: evidence synthesis and critical reappraisal of surgical techniques2008 · 99 citations
  5. 5Effect of Chordal Preservation on Left Ventricular Function2005 · 33 citations