From January, 1994 to January, 1996, mitral valve replacement was performed in 27 patients. Among these, 17 patients underwent mitral valve replacement(MVR) with preservation of the annulo-papillary continuity(PAPC-MVR) (-Group I), and 10
patients
underwent conventional methods of excision of all the chordae(-Group II).
The operative technique for PAPC-MVR consists of the division of the anterior leaflet into anterior and posterior segments, shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas.
This retrospective study has been designed to evalute the postoperative left ventricular function in the two groups. In the group. I, LVEF(Left Vnetricular Ejection Fraction:%) was 52±3 preoperatively and 50±3 postoperatively, LVESVI(Left
Ventricular
End Systolic Volume Index:mL/m2) was 59±6 and 51±7, LVEDI(Left Ventricular End Diastolic Volume Index:mL/m2) was 124±11 and 91±8. In the group II, LVEF was 56±1 and 47±3, LVESVI 62±12 and 61±15., LVEDVI 113±27 and 104±17. : the
variation
of
the LVEF in these two group was statistically different(p<0.05). A comparison of left ventricular function data between Group I(n=17) and Group II(n=10) revealed better results in echocardiographic LVEF(p<0.05), LVEDVI(p<0.01) in the former
group.
The
mean functional class(NYHA) was 2.6 preoperative and improved to 1.0 postoperatively in group I, and 2.8 and to 1.0 in group II.
We conclude that maintenance of continuity between the mitral annulus and papillary muscles is expected to have a beneficial effect on postoperative left ventricular performance.±±±
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