Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Comparison of hemodynamic parameters in early postoperative period using resection and creating artificial chords techniques caused by pos- terior mitral leaflet prolapse

Authors: Bel'skiy V.V., Muratov R.M., Sachkov A.S., Soboleva N.N., Fadeev А.А.

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russia, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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UDC: 616.422-007.2-089.168.1:612.13-07

Link: Clinical Physiology of Blood Circulaiton. 2016; 13 (1): 45-51

Quote as: Bel'skiy V.V., Muratov R.M., Sachkov A.S., Soboleva N.N., Fadeev А.А. Comparison of hemodynamic param- eters in early postoperative period using resection and creating artificial chords techniques caused by posterior mitral leaflet prolapse. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2016; 13 (1): 45–51 (in Russ.).

Received / Accepted:  12.11.2015/02.02.2016

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Abstract

Objective – to comparison of hemodynamic parameters in early postoperative period using resection and creating artifi- cial chords techniques caused by posterior mitral leaflet prolapse.
Material and methods. In department from 2007 to 2013 162 operations were done: correction of severe mitral regurgi- tation due to various patologies. The immediate results were analyzed retrospectively in 48 patients. Patients were divided into 2 groups. In the first group resection technique was used (n=32) (quadratic resection of posterior mitral leaflet), and the second – creating artificial chords (n=16) (neochord creation using PTFE 4-0). Also, all the reconstructions included PTFE band annuloplasty (fixed length – 6 cm).
Results. Hospital mortality in the first was group was 3%, in the second were no deaths. In the first group 69% patients have no regurgitation or was trivial, first degree of regurgitation showed in 28%, and 3% have second degree. In the sec- ond group trivial regurgitation or its absence was detected in 82% of patients, first degree regurgitation was in 18% cases, there was no regurge in second group. Significant differences between the groups were detected comparing the mean transvalvular gradients. Compared with the preoperative indicators in the first and second groups showed a significant decrease in end-diastolic volume (EDV), reducing the size of the left atrium (LA), reducing also the diameter of mitral valve (MV) annulus. In the second group was significantly decreased ejection fraction (EF), in the first group there was no sig- nificant differences. There was no significant differences between the two groups in EF, EDV, the size of the LA, the diam- eter of MV annulus.
Conclusions. These methods both show good results, effectively correcting hemodynamics and reproduce as close as possible the normal blood flow through mitral valve.

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