[Left ventricular systolic and diastolic function after mitral valve replacement with preservation of posterior chordae tendineae].
Left ventricular function was compared in 14 patients who underwent mitral valve replacement with preservation of the posterior leaflet, chordae tendineae and papillary muscle (preserved group) and 14 patients who underwent conventional mitral valve replacement (non-preserved group). 99mTc radionuclide ventriculography was performed before surgery and one month after surgery. The early diastolic filling rate, an indicator of the efficiency of diastolic function, was measured. The patients in the non-preserved group showed an anteroseptal ejection fraction of 28 +/- 10% before surgery and 32 +/- 10% after surgery, an apical ejection fraction (71 +/- 10% vs 73 +/- 16%), and an inferolateral ejection fraction (56 +/- 16% vs 53 +/- 16%). The global ejection fraction tended to decrease from 56 +/- 9% to 52 +/- 10%. The patients in the preserved group showed an anteroseptal ejection fraction of 37 +/- 13% before surgery and 43 +/- 19% after surgery, an apical ejection fraction (74 +/- 20% vs 77 +/- 17%) and an inferolateral ejection fraction (53 +/- 11% vs 68 +/- 16%). The global ejection fraction, reflecting improvement in the inferolateral ejection fraction, tended to increase from 53 +/- 11% to 58 +/- 11%. The early diastolic filling rate for the preserved group was 1.73 +/- 0.43 before surgery and 1.05 +/- 0.61 after surgery, while that for the nonpreserved group was 1.59 +/- 0.24 vs 0.97 +/- 0.48. Although the early diastolic filling rate normalized in both groups, there was no significant difference between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Matsumoto
Y
Y
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Kawasuji
M
M
Sakakibara
N
N
Takemura
H
H
Ushijima
T
T
Kawase
Y
Y
Fujii
S
S
Watanabe
Y
Y
D002815:Chordae Tendineae / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D013318:Stroke Volume; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*