MITRAL VALVE REPAIR WITHOUT RING- OUR CENTRE EXPERIENCE
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Keywords
Mitral valve stenosis, Mitral valve repair, Mitral valve, Mitral valve repair without ring, Annuloplasty.
Abstract
Mitral stenosis is common pathological entity which followed Rheumatic Heart Disease(RHD). Various other type of manifestations are Mitral Regurgitation(MR), Aortic Stenosis/Regurgitation etc. Our study is focused on predominant mitral stenotic lesion with Left Atrial Appendage(LAA)/Left Atrial(LA) body Clot, with trivial to mild MR, with or without other valvular lesions. Mitral repair without ring yields following benefits. Low perioperative mortality rate, preservation of Left Ventricle function, avoidance of long term anticoagulation therapy, decreased thromboembolic complications, low risk of native-valve endocarditis and long term freedom from replacement of valve. In our original research article, study of mitral valve repair without ring was done which include commissurotomy decalcification of leaflets or commissure along with papillary muscles and chordal lengthening.
Material and Methods: Our study includes the mitral valve repair without ring, operated at our centre in from October 2015 to January 2017.
Results: In this study majority of the patients were males (36) and maximum number of patients were in 3rd and 4th decade. Most of the patients were in New York Heart Association (NYHA) class III. The most common procedure performed was Mitral valve repair without rim with LAA clot removal (26) and the post-operative mitral valve area achieved was in the range of 1.6 cm^2-1.9 cm^2 (33). In our study significant MR occurred in 2 cases during decalcification of leaflets. This MR was managed by annuloplasty ring repair in 1 case and replacement of valve in other case.
Conclusion: In our original article we establish that Mitral valve repair without ring is simple, safe and effective and more economical method for management of severe MS with LA/LAA clot. But it requires lot of expertise.
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Rajeshwar Yadav
Assistant Professor, Department of Cardiothoracic and Vascular Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Swati Pathak
Assistant Professor, Department of Cardiothoracic and Vascular Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Rakesh Verma
Professor, LPS Institute Of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India.
