EARLY MORTALITY & MORBIDITY IN MITRAL VALVE REPLACEMENT WITH TOTAL SUB-VALVULAR APPARATUS PRESERVATION, PARTIAL PRESERVATION AND NO PRESERVATION - A COMPARATIVE STUDY

  • Muhammad Ashfaq Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Nasir Ali Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Asif Mahmood Janjua Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Naser Ali Khan Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Imran Ashgar Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Kifayat Ullah Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Yasir Javed Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Keywords: Mitral Valve Replacement, Subvalvular Apparatus preservation, Operative Techniques

Abstract

Objective: To compare the early morbidity & mortality of total sub-valvular apparatus preservation technique vs partial preservation technique and no preservation technique in mitral valve replacement.

Study Design: Cross-sectional comparative study.

Place and Duration of Study: Department of Cardiac Surgery, Armed Forces Institute of Cardiology Rawalpindi, from Jan 2017 to Dec 2018.

Methodology: One hundred fifty seven patients who underwent Mitral valve replacement were included in study. These patients were divided into three groups; group “A” comprised of those patients with total subvalvular apparatus preservation (n1=46), group “B” comprised of those patients with partial sub-valvular apparatus preservation (n2=70), group “C” comprised of those patients with no sub-valvular apparatus preservation
(n3=41).

Results: There were no statistical difference in the pre-operative data of the patients. No statistical difference noted in cross clamp & bypass time (p>0.05). The early morbidity in terms of ICU stay, Ventilation time, Inotropic supports, post-operative bleeding, Blood transfusion, postoperative rhythm abnormality & Re-exploration were statically significant (p<0.05). The mortality rate of patients with total sub-valvular apparatus preservation was 2.17% which is significantly less than those with partial preservation (2.85%) & no preservation (9.75%).

Conclusions: Mitral valve replacement with total subvalvular apparatus preservation had low postoperative morbidity & mortality in comparison with partial and no preservation techniques.

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Published
2021-01-05
How to Cite
Ashfaq, M., Ali, N., Janjua, A., Khan, N., Ashgar, M., Ullah, K., & Javed, Y. (2021). EARLY MORTALITY & MORBIDITY IN MITRAL VALVE REPLACEMENT WITH TOTAL SUB-VALVULAR APPARATUS PRESERVATION, PARTIAL PRESERVATION AND NO PRESERVATION - A COMPARATIVE STUDY. Pakistan Armed Forces Medical Journal, 70(Suppl-4), S715-20. https://doi.org/10.51253/pafmj.v70iSuppl-4.6006

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