Effect of Partial Versus Complete Annulo-Papillary Preservation During Mitral Valve Replacement on Left Ventricular Geometry and Function Using CMR

Abdalraouf, Mostafa M.; Khalil, Mohamed Abdalraouf; Gafaar, Ahmed Hussein; Ramadan, Ahmed; Fouda, Tamer Eid; Behairy, Noha; Abuldahab, Mohamed

doi:10.21608/ejhm.2022.260866

Effect of Partial Versus Complete Annulo-Papillary Preservation During Mitral Valve Replacement on Left Ventricular Geometry and Function Using CMR

Document Type : Original Article

Authors

10.21608/ejhm.2022.260866

Abstract

Background: Evaluation of left ventricular function after mitral valve surgery was always debated. Evolution of new diagnostic techniques as cardiovascular magnetic resonance imaging (CMR) may help in discovering advantages or disadvantages of different surgical techniques used during mitral valve surgery. Many comparative studies were done depending on the traditional diagnostic methods as Echocardiography.
Objective: The aim of the current work was to assess the immediate and short-term effect of partial and complete annulo-papillary preservation on left ventricular function and geometry, using CMR, in patients undergoing mitral valve replacement for predominant mitral incompetence.
Patient and methods: Prospective randomized controlled trial study, on 32 patients with mitral valve disease and predominant mitral regurgitation, mitral valve replacement was done. The study was done at different institutions (Kasr AlAiny hospitals, Sheikh Zayed specialized Hospital), with the same group of surgeons, in the period between May 2015 and Feb 2017. All patients went throughpreoperative, operative& early postoperative evaluation.
Results: According to our knowledge this is the first study in Egypt to use CMR in evaluating the effect of mitral valve replacement on cardiac function. Postoperative evaluation demonstrated a significant improvement in left ventricular function and dimensions in both groups using echocardiography or CMR. The study failed to quantify significant superiority of either technique in our selected patient groups. This was consistent with many trails done before using echocardiography only.
Conclusion: CMR as an available investigation should be used in a larger scale specially in debatable conditions regarding cardiac function and in tissue evaluation. Mitral valve repair is the gold standard whenever possible during surgical management of mitral valve disease, but mitral replacement is a modality may be needed in many situations. Every effort should be exerted to avoid complete separation of the annulo-papillary continuity during mitral valve replacement.

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