Key result
Complete preservation of subvalvular structures during mitral valve replacement significantly decreased left ventricular end-systolic volume compared to preserving only the posterior leaflet.
Why the study?
The study was conducted to evaluate the advantage of preserving subvalvular structures from both mitral valve leaflets compared with preservation from only the posterior valve during mitral valve replacement surgery.
Does complete preservation of subvalvular structures during mitral valve replacement improve early left ventricular remodeling compared to preserving only the posterior leaflet in patients with rheumatic mitral valve disease?
Population
41 patients with isolated rheumatic lesions of the mitral valve undergoing MVR
Comparison
Complete preservation of subvalvular structures vs preservation of only the posterior leaflet
Design
Retrospective analysis
Authors
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May support early LV remodeling benefit with complete chordal preservation in rheumatic MVR; hypothesis-generating and requires RCT confirmation before practice change.
Cohort (n=41)
No
Does complete preservation of subvalvular structures during mitral valve replacement improve early left ventricular remodeling compared to preserving only the posterior leaflet in patients with rheumatic mitral valve disease?
Absolute Event Rate: 37.1% vs 52%
p-value: p=<0.05
Complete preservation of subvalvular structures during mitral valve replacement for rheumatic disease leads to better early postoperative left ventricular remodeling compared to preserving only the posterior leaflet.
Toktosunova et al. (2020) conducted a cohort in Rheumatic mitral valve disease (n=41). Complete preservation of subvalvular structures vs. Preservation of only the posterior leaflet subvalvular structures was evaluated on Left ventricular end-systolic volume (LVESV) before discharge (p=<0.05). Complete preservation of subvalvular structures during mitral valve replacement significantly decreased left ventricular end-systolic volume compared to preserving only the posterior leaflet.
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