Comparison of Midterm and Long-Term Effects of Cord Protection Methods on Left Ventricular Function in Mitral Valve Replacement Surgery

Abstract

Introduction: Our study aimed to determine the effects of cord protection methods applied in Mitral valve replacement (MVR) surgery on left ventricular function. Materials and Methods: MVR surgery was performed on 634 patients using either single or combined procedures. Of these patients, 358 (56.5%) underwent conventional MVR surgery, 121 (19.1%) underwent total chordal protection, and 155 (24.4%) underwent posterior chordal preservation. All patients were evaluated as class 3 and 4 according to the New York functional classification (NYHA). Left ventricular diastolic end-diameter (SVDSD), left ventricular systolic end-diameter (SVSSD), end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) were compared between groups. Results: The degree of valve insufficiency was 3 and 4 in patients with mitral insufficiency. The mortality risk for patients undergoing conventional surgical operations was 4.257 times higher (OR:4.25; 95%CI:1.22-14.76). The study showed positive effects of chordal protection on the clinical status and echocardiographic parameters of undergoing MVR surgery (p<0.01). Conclusion: We believe cord protection methods positively affect left ventricular function after MVR. In particular, total chordal protection will positively affect left ventricular function.