Objective To summarize clinical outcomes of mitral valve replacement (MVR) with modified anterior leaflet preservation technique,improve therapeutic effects and reduce postoperative mortality and morbidity. Methods From May 2005 to December 2012,128 patients underwent MVR with modified anterior leaflet preservation technique (modified group) in Beijing Anzhen Hospital,among whom 14 patients received concomitant aortic valve replacement. There were 49 male and 79 female patients in the modified group with their age of 45.0±12.3 years. Another 128 patients who underwent routine MVR during the same period were also included in this study as the control group,including 55 male and 73 female patients with their age of 48.0±8.4 years. There was no statistical difference in preoperative clinical characteristics between the 2 groups (P>0.05). Results In the modified group,there was no perioperative death. Postoperatively,6 patients received reexploration for bleeding,4 patients had low cardiac output syndrome,5 patients had pulmonary infection,1 patient received tracheostomy,and 3 patients had acute kidney failure (AKI). In the control group,5 patients died postoperatively including 3 patients with left ventricular rupture and 2 patients with severe low cardiac output syndrome. Postoperatively,5 patients received reexploration for bleeding,12 patients had low cardiac output syndrome,4 patients had pulmonary infection,and 6 patients had AKI. Echocardiography at 6th month during follow-up showed that left ventricular ejection fraction (LVEF) left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) of modified group patients were improved compared with control group patients. There was statistical difference in LVEF and LVESD between the 2 groups (P<0.05). There was no statistical difference in LVEDD between the 2 groups (P>0.05). LVEF,LVEDD and LVESD of modified group patients during follow-up were statistically different from preoperative values (P<0.05). LVEDD of control group patients during follow-up was statistically different from preoperative LVEDD (P<0.05). LVEF and LVESD of control group patients during follow-up was not statistically different from preoperative values (P>0.05). Conclusion MVR with modified anterior leaflet preservation technique is simple to perform with satisfactory short-term results. This technique is suitable for various types of mitral valve diseases especially degenerative mitral valve disease and infective endocarditis.

Citation： LIJi-yong, ZHANGJian-qun, BOPing, ZHANGFu-en, ZHAOShuang. Mitral Valve Replacement with Modified Anterior Leaflet Preservation Technique. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(2): 189-193. doi: 10.7507/1007-4848.20140056 Copy

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