Mitral Valve Replacement with Chordal Preservation in Mitral Stenotic Disease / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Mitral valve replacement with chordal preservation in patients with mitral regurgitation has been proved to be beneficial for left ventricular function and for reduction of postoperative complication. However, in patients with mitral stenosis, the effectiveness of the technique is controversial. It is not easy to insert prosthetic valve without left ventricular outflow tract obstruction and prosthetic valve leaflet motion hinderance. MATERIAL AND METHOD: Five patients with mitral stenosis and seven patients with mitral stenoinsufficiency underwent mitral valve replacement with preservation of mitral subvalvular apparatus. Thickened and calcified leaflets are made thin by peeling off the thickened and calcified part. Commissurotomy was done and anterior leaflet was incised 2 mm apart from the annulus and then divided into two segments. Anterolateral and posteromedial segments including strut chordae, were reattached to mitral commissural area, respectively. RESULT: There was no evidence of prosthetic valve dysfunction, paravalvular leakage, left ventricular outflow tract obstruction, complications and operative or late deaths. CONCLUSION: We conclude that mitral vlave replacement with chordal preservation was safe and effective technique for the patients with mitral stenotic disease.