Preservation of Rear Wing with a Subvalvular Structure in Mitral Prosthetics

The goal is to evaluate the effectiveness of the immediate results (not more than 6 months) of the mitral valve prosthetics operation with preservation of the posterior valve with the chordal-papillary apparatus. Material and methods: the study included 96 patients after surgery with preservation of the posterior mitral valve cusp. The average age of the patients was 45.9±12.0 years. The inclusion criteria were the final diastolic size (CRD) of the left ventricle (LV) and ejection fraction. Results: in the immediate postoperative period was observed a decrease in the final systolic and diastolic sizes and volumes of the left ventricle. A similar dynamics was noted in relation to the size of the left atrium. The pressure gradient on the mitral prosthesis and the systolic pressure in the pulmonary artery decreased. The ejection fraction of the left ventricle in the near postoperative period increased on average 57.9±9.8 before surgery and 59.2±8.2 after surgery. According to echocardiography, there were no cases of dysfunction of the artificial heart valve or prosthesis-dependent complications due to preserved cusp tissue or chords of the posterior cusp, and there was a positive dynamics of remodeling of the left ventricle. The surgical technique of preserving the posterior valve with its chordal-papillary apparatus is simple in surgical execution and does not lengthen the time of cardiopulmonary bypass (57.3±26.1 min).