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June 1, 1987The Thoracic and Cardiovascular Surgeon

Importance of the Mitral Complex in Left Ventricular Contraction - an Analysis of the Results of Mitral Valve Replacement with Preservation of the Posterior Mitral Complex

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Why the study?

Does modified MVR with preservation of the posterior mitral complex improve left ventricular function compared to conventional MVR in patients undergoing mitral valve replacement?

Population

197 patients undergoing mitral valve replacement (MVR) for mitral regurgitation or mitral stenosis

Comparison

Modified mitral valve replacement with… vs Conventional mitral valve replacement (cMVR)

Design

Cohort

Follow-up

Initial 24 hours following cardiopulmonary bypass

Authors

KYK YagyuThe University of TokyoHMHisako MatsumotoSoai UniversityKAK AsanoChukyo Hospital

Discussion

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Implication

Supports posterior mitral preservation in MVR for better early hemodynamics; leaves open whether RCTs confirm long-term benefit.

Structured PICO

Does modified MVR with preservation of the posterior mitral complex improve left ventricular function compared to conventional MVR in patients undergoing mitral valve replacement?

P
Population
197 patients undergoing mitral valve replacement (MVR) for mitral regurgitation or mitral stenosis
I
Intervention
Modified mitral valve replacement (mMVR) with preservation of the posterior mitral complex using mechanical heart valves (Medtronic Hall or St. Jude Medical)
C
Comparator
Conventional mitral valve replacement (cMVR)
O
Outcome
Left ventricular function (left atrial pressures, left ventricular stroke work indexes, catecholamine requirement) during the initial 24 hours following cardiopulmonary bypass, and sequential apex-to-base contraction on M-mode echocardiographysurrogate

Preservation of the posterior mitral complex during mitral valve replacement improves postoperative left ventricular hemodynamics and preserves sequential apex-to-base contraction.

Cite This Study

Yagyu et al. (1987) studied this question.

synapsesocial.com/papers/6a952c25aec9be1889e3c7fchttps://doi.org/10.1055/s-2007-1020222

Topics

Mitral valve interventionEchocardiography
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Also Consider

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

  1. 1An Evaluation of Left Ventricular Function after Surgery for Pure Mitral Regurgitation Using Dobutamine-stress Echocardiography. Should the Mitral Complex Be Preserved?1999 · 1 citations
  2. 2The impact of complete versus partial preservation of the sub‐valvular apparatus on left ventricular function in mitral valve replacement2022 · 3 citations
  3. 3Complete Preservation of the Mitral Valve Apparatus during Mitral Valve Replacement for Rheumatic Mitral Regurgitation in Patients with an Enlarged Left Ventricular Chamber2013 · 16 citations
  4. 4Left Ventricular Function, Twist, and Recoil After Mitral Valve Replacement1995 · 48 citations
  5. 5Improvement in Left Cardiac Function Following Mitral Valve Repair: Analyses Based on Cardiac Magnetic Resonance Imaging2020 · 4 citations