Safety and feasibility of mitral valve replacement with valve structures reserved under cardiopulmonary bypass
Cao Quansheng
Wang Yongsheng
Zhang Junwei
Shi Xinge
Abstract：Objective To analyze the safety and feasibility of mitral valve replacement with mitral valve and valve structures reserved under cardiopulmonary bypass.Methods Clinical data of 105 patients who underwent mitral valve replacement under cardiopulmonary bypass from January 2006 to June 2014 were enrolled and randomly divided into group A,B and C.During mitral valve replacement,the mitral valve and valve structures were removed in group A;these structures were reserved in group B and they were partly reserved in group C.The echocardiographic changes,hemodynamic parameters and postoperative complications were statistically analyzed.Results Ten days and 3 months after operation,the left ventricular end systolic diameter,left ventricular enddiastolic diameter,left ventricular fractional shortening and left ventricular ejection fraction in group B and group C were significantly improved compared with those in group A [10 days after operation:(41 ± 5),(38 ± 5) mm vs (45 ±5) mm,(59 ±6),(53 ±7) mm vs (61 ±6) mm,(31 ±4)％,(34 ±4) ％ vs (29 ±4) ％,(61 ±6)％,(62 ±7)％ vs (58 ±6) ％;3 months after operation:(43 ±5),(35 ±5) mm vs (42±5) mm,(61 ±5),(52 ±4) mm vs (59 ±5) mm,(33 ±3)％,(36±3)％ vs (32±3)％,(62±5)％,(66 ±6)％ vs (59 ±5)％](all P ＜0.05).The mean pressures of pulmonary artery and pulmonary vascular resistance were significantly higher and the cardiac index and left ventricular-stroke work index (LVSWI) were significantly lower in group A than those in group B and group C [(5.8 ±0.6) kPa vs (4.4 ±0.9),(4.5 ±0.9) kPa;(50 ± 13) kPa · s/L vs (34 ± 10),(36±16) kPa· s/L;(2.6 ±0.5) L/(min · m2) vs (3.2±0.4),(3.1 ±0.5) L/(min · m2);(1.9±0.5) mJ/m2 vs (3.7±0.9),(3.3 ±0.4) mJ/m2] (P ＜0.05);the pulmonary capillary wedge pressure (PCMP) 4,24 and 48 h after operation was significantly different among the three groups [4 h after operation:(2.2±0.6) kPavs (1.6±0.6) kPavs (1.4±0.4) kPa,24 h after operation:(2.4±0.4) kPavs (1.7±0.4) kPa vs (1.6 ± 0.4) kPa,48 h after operation:(2.5 ± 0.4) kPa vs (1.5 ± 0.3) kPa vs (1.6 ± 0.5) kPa](P ＜ 0.05);24 h after operation,the LVSWI in group A was significantly lower than that in group B [(2.2 ±0.7) mJ/m2 vs (3.1 ± 1.0) mJ/m2] (P ＜0.05).The incidence of early postoperative complications and mortality rate were significantly higher in group A compared with those in group B and group C [31.4％ (11/35) vs 17.1％ (6/35),14.3％ (5/35);11.4％ (4/35) vs 5.7％ (2/35),2.9％ (1/35)] (P ＜0.05).Conclusion Mitral valve replacement with mitral valve and valve structures reserved under cardiopulmonary bypass is safe and feasible.
Keywords：Mitral valve replacementCardiopulmonary bypassMitral valve and valve structures reservedSafetyFeasibility
Publication Date：2015-10-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1418-1422 )