Clinical Study Of Left Ventricular Function After Mitral Valve Replacement For Mitral Regurgitation

Mitral regurgitation (MR) is a common heart valve disease, mitral systolic rely onthe integrity of the mitral valve system, mitral valve device including the valve leaflets,valve ring, chordae and papillary muscle, in which any part of the structure is damaged,may lead to MR. MR can lead to left ventricular volume overload, gradual progressionto left ventricular dysfunction, seriously affecting the patient’s quality of life andsurvival rate. MR’s treatment of Mitral valve plasty (MVP) and Mitral valvereplacement (MVR). Because of MVP with gently cardiac structural damage, lowermortality rate, higher long-term survival rate, and lower incidence of blood clots, whithhave been agreed by more scholar. Because it have the advantage of gently mitral valvedestruction, intact of the subvalvular, basically to maintain the normal physiologicalstructure, this technique has been widely applied in clinical treatment for MR.Objective: Summary of54cases of MR in patients who undergone mitral valveplasty, record their data of preoperative, postoperative, and follow-up byechocardiography. Through the comparative study to explore the left ventricularfunction change after MVP, and then evaluate the Impact on left ventricular function ofMVP.Methods: chose54MR patients who hospitalized in the period from February2007to March2012, the Second Affiliated Hospital of Dalian Medical University,39cases were male and15females, average age56±10years; preoperative cardiacfunction gradeⅡ~gradeⅣ. All patients undergone mitral valve plasty in the moderatehypothermic cardiopulmonary bypass, collected echocardiography resultspreoperatively, after surgery1week,2weeks,1month and3months，then comparativeanalysis of left atrial diameter (LA), left ventricular end-diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), changes of the mitral valve area (MVA),at each time point data were analyzed.Results: All the operations were successful, no operative mortality. We followedup the patients more than three months. No one was lost in three months. During thefollow up, patients whose heart function restore to the gradeⅠ，29cases (53.7%), to thegradeⅡ,25cases (46.3%); all cases of heart murmur disappeared, does not appearsignificant complications of bleeding, thrombosis. During the early postoperative periodof one or two weeks, we observed the patients’ LVEF, LVFS compared to preoperativewere declined. But after1month and3month, we observed an upward trend innumerical; LA, LVEDD, LVESD were showed a progressive trend of decrease aftersurgery.Conclusion：MVP can protect the left ventricular function and left ventricularreconstruction after. Due to poor preoperative cardiac function, the effect of surgery,and other factors, left ventricular function in short term have decreased to some extent,but cardiac function can get a good recovery in long term.