IMPACT OF THE PRESERVATION OF THE SUBVALVULAR APPARATUS OF THE ANTERIOR MITRAL LEAFLET ON THE LEFT VENTRICULAR FUNCTION AFTER MITRAL VALVE REPLACEMENT IN EARLY POST-OPERATIVE PERIOD

Background:Long-term morbidity and mortality appear to be associated with mitral valve replacement for mitral valve disease. The morbidity rate has not decreased dramatically over the years, despite enhancements in myocardial safety and prosthetic valves. Cardiac failure is the most common cause of death following MVR. Subvalvular apparatus preservation preserves LV function and thus improves survival. Repair, particularly with rheumatic valve disease in young patients and extremely disorganised valves, is not always feasible or effective. The use of smaller valve prothesis was not only the argument of preserving the anterior leaflet, but also that it could cause LVOT obstruction.

Methods:A prospective controlled randomized study will include(sixty patients aged from 25 to 55 years of both sexes)

They will be divided into two groups of patients:

Group I: thirty patients who underwent MVR without preservation of

The chordae tendinae of the anterior mitral leaflet and only preserving

the posterior mitral leaflet.

Group II: thirty patients who underwent MVR with complete or partial

Preservation of the chordae tendinaeof the anterior mitral leaflet.

Results:The sixty patients were divided into two groups where 30 of them underwent preservation of AML,

These patients had a better LV function in the early and the short term

 postoperative period.

Conclusion:Results of this study concluded that preservation of the AML leads to better postoperative outcome. We recommend its application on a greater scale of cases of MVR.