PMID- 8793680
OWN - NLM
STAT- MEDLINE
DCOM- 19961119
LR  - 20060504
IS  - 0966-8519 (Print)
IS  - 0966-8519 (Linking)
VI  - 5
IP  - 3
DP  - 1996 May
TI  - Long term results of mitral valve replacement with preservation of the posterior 
      leaflet.
PG  - 302-6
AB  - BACKGROUND AND AIMS OF THE STUDY: It is commonly held that preservation of the 
      annulo-ventricular continuity during mitral valve replacement has a beneficial 
      effect on postoperative ventricular function. This paper presents our eight-year 
      experience with this technique. MATERIALS AND METHODS: From 1986 to December 
      1992, 120 patients with rheumatic valve disease underwent mitral valve 
      replacement (MVR) combined with preservation of the posterior leaflet of the 
      mitral valve. The mean age was 33.87 years (range 16 to 63). The preoperative New 
      York Heart Association (NYHA) class was III in 64% of the patients and IV in 3%. 
      The early (30 day) mortality rate was 2.5% (3/120). Follow up was 100% complete. 
      The total cumulative follow up was 477 patient-years (pty) with a mean 3.94 years 
      (range: 2-8 years). RESULTS: The actuarial survival rate (including hospital 
      mortality) was 87.6% at eight years. Advanced age (p = 0.0457), increased 
      preoperative functional capacity (p = 0.0251), increased preoperative 
      end-systolic diameter (p = 0.0352) and combined tricuspid reconstruction (p = 
      0.0001) were found to be independent parameters for a lower actuarial survival 
      rate. Six patients (1.25%/pty) developed thromboembolic complications. Two of 
      these were cerebrovascular accidents (0.41%/pty) and four were caused by 
      mechanical valve thrombosis (1.83%/pty). Freedom from thromboembolic 
      complications (including mechanical valve thrombosis) was 89.8% +/- 7.9%. Fifteen 
      patients (3.14%/pty) developed valve failure, four (0.83%/pty) mechanical valve 
      thrombosis and nine (1.88%/pty) bioprosthetic valve failure. Freedom from 
      reoperation was 60.7% +/- 16.1%. One patient with a St. Jude Medical valve 
      (0.2%/pty) suffered from prosthetic valve endocarditis. Three patients 
      (0.62%/pty) died during the follow up period, and, freedom from all valve related 
      complications was 51.4% +/- 16.1% at eight years. CONCLUSION: Preservation of the 
      posterior leaflet during mitral valve replacement reduces the risk of early 
      mortality and did not cause additional complications to the patients. Despite the 
      beneficial effects of this technique in the long term this technique did not 
      increase the long term survival in patients with associated impaired valvular 
      and/or ventricular function.
FAU - Katircioglu, F
AU  - Katircioglu F
AD  - Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital of Ankara, 
      Turkey.
FAU - Yamak, B
AU  - Yamak B
FAU - Battaloglu, B
AU  - Battaloglu B
FAU - Saritas, A
AU  - Saritas A
FAU - Kiziltepe, U
AU  - Kiziltepe U
FAU - Kural, T
AU  - Kural T
FAU - Tasdemir, O
AU  - Tasdemir O
FAU - Bayazit, K
AU  - Bayazit K
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Heart Valve Dis
JT  - The Journal of heart valve disease
JID - 9312096
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis/*methods/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/etiology/mortality/*surgery
MH  - Mitral Valve Stenosis/etiology/mortality/*surgery
MH  - Postoperative Complications/mortality
MH  - Retrospective Studies
MH  - Rheumatic Heart Disease/complications/surgery
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 1996/05/01 00:00
MHDA- 1996/05/01 00:01
CRDT- 1996/05/01 00:00
PHST- 1996/05/01 00:00 [pubmed]
PHST- 1996/05/01 00:01 [medline]
PHST- 1996/05/01 00:00 [entrez]
PST - ppublish
SO  - J Heart Valve Dis. 1996 May;5(3):302-6.