EARLY MORTALITY & MORBIDITY IN MITRAL VALVE REPLACEMENT WITH TOTAL SUB-VALVULAR APPARATUS PRESERVATION, PARTIAL PRESERVATION AND NO PRESERVATION - A COMPARATIVE STUDY

Abstract

Objective: To compare the early morbidity & mortality of total sub-valvular apparatus preservation technique vs partial preservation technique and no preservation technique in mitral valve replacement. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Cardiac Surgery, Armed Forces Institute of Cardiology Rawalpindi, from Jan 2017 to Dec 2018. Methodology: One hundred fifty seven patients who underwent Mitral valve replacement were included in study. These patients were divided into three groups; group “A” comprised of those patients with total subvalvular apparatus preservation (n1=46), group “B” comprised of those patients with partial sub-valvular apparatus preservation (n2=70), group “C” comprised of those patients with no sub-valvular apparatus preservation (n3=41). Results: There were no statistical difference in the pre-operative data of the patients. No statistical difference noted in cross clamp & bypass time (p>0.05). The early morbidity in terms of ICU stay, Ventilation time, Inotropic supports, post-operative bleeding, Blood transfusion, postoperative rhythm abnormality & Re-exploration were statically significant (p<0.05). The mortality rate of patients with total sub-valvular apparatus preservation was 2.17% which is significantly less than those with partial preservation (2.85%) & no preservation (9.75%). Conclusions: Mitral valve replacement with total subvalvular apparatus preservation had low postoperative morbidity & mortality in comparison with partial and no preservation techniques.

Keywords

• mitral valve replacement
• subvalvular apparatus preservation
• operative techniques