Key result
Bilateral and partial chordo-papillary preservation during mitral valve replacement significantly improved left ventricular ejection fraction at 6 months compared to complete excision (P<0.001).
Why the study?
Disruption of the mitral valve apparatus during mitral valve replacement has been postulated as a risk factor for postoperative ventricular dysfunction.
Does single or bilateral chordo-papillary apparatus preservation improve left ventricular function compared to no preservation in patients undergoing mitral valve replacement?
Population
60 patients who had MVR
Comparison
Single vs bilateral chordo-papillary preservation vs complete excision of subvalvular chordae and papillary muscle tips
Design
Cohort study
Follow-up
6 months
Authors
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Preservation of chordo-papillary apparatus was associated with better LVEF after MVR; leaves open whether randomized trials should change practice.
Observational (n=60)
Does single or bilateral chordo-papillary apparatus preservation improve left ventricular function compared to no preservation in patients undergoing mitral valve replacement?
Absolute Event Rate: 56.6% vs 45.32%
p-value: p=<0.001
Preservation of the chordo-papillary apparatus during mitral valve replacement significantly improves postoperative left ventricular function and reduces ICU and mechanical ventilation times compared to complete excision.
Shalaby et al. (2020) conducted an observational in Mitral valve replacement (n=60). Bilateral or partial chordo-papillary apparatus preservation vs. Complete excision of the subvalvular chordae and tips of papillary muscles was evaluated on Left ventricular ejection fraction at 6 months (p=<0.001). Bilateral and partial chordo-papillary preservation during mitral valve replacement significantly improved left ventricular ejection fraction at 6 months compared to complete excision (P<0.001).
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