| Objective:The purpose of this study is to compare the treatment effect of traditional Mitral Valve Replacement (MVR) Surgery with mural leaflet and subvalvular apparatus sparing MVR Surgery under Cardiopulmonary Bypass (CPB) and to obtain a better surgical treatment method for MVR Surgery.Method:A retrospective analysis study was performed on a total of 103 patients whom underwent a traditional Median Sternotomy (MS) MVR Surgery under CPB in the Cardiothoracic Department of Guangxi Medical University’s 1st Affiliated Hospital from the period 1st January 2014 until 31st December 2014. The study groups are divided into experimental group of 47 cases with mural leaflet and subvalvular apparatus sparing MVR surgery and the control group of 56 cases with a traditional non-sparing MVR Surgery. The study includes the data comparison of total surgery time, cardiac resuscitation time, post-surgical intubation time and CCU care time; cardiothorax ratio (CR) and Tei-index, Z-index,left ventricle end-diastolic diameter (LVEDD),left ventricle end-systolic diameter (LVESD), left ventricle ejection fraction (LVEF%) and right ventricle ejection fraction (RVEF%) as heart function index comparison.Results:In the study, there is no hospitalization and surgical mortality, all patients were discharge in a healthy condition. (1) There is no statistical significance (P>0.05) on the comparison of total surgical time, cardiac resuscitation time, pre and post-surgical CR and heart function index on both group studies; (2) The comparison of experimental group and control group data on post-surgical intubation and CCU care period are (8.4±2.8) hours versus (9.7±2.4) hours and (10.5±4.1) hours versus (12.7±4.8) hours; (3) 3 months and 6 months post-surgical CR comparison are 0.58±0.21 versus 0.62±0.27 and 0.51±0.15 versus 0.56±0.20; (4) 3 months and 6 months post-surgical heart function index comparison are Tei-index 0.82±0.24 versus 0.99±0.34 and 0.61±0.16 versus 0.79±0.32; Z-index 0.69±0.25 versus 0.45±0.17 and 0.93±0.34 versus 0.67±0.33; LVEDD comparison are 52.6±6.4 mm versus 56.1±6.9 mm and 51.1±6.8 mm versus 54.9±7.2 mm; LVESD comparison are 41.8±6.9 mm versus 44.7±7.5 mm and 40.3±6.5 mm versus 43.1±7.3 mm LVEF% comparison are 62.3±6.2 versus 56.6±5.7 and 65.5±7.0 versus 58.3±6.3; RVEF% comparison are 61.5±7.8 versus 57.7±7.9 and 64.2±6.9 versus 59.8±7.8. Both groups has a significant post operation improvement (P<0.05), but the post-surgical heart function index on the experimental group were significantly better than the control group (P<0.05).Conclusion:Both traditional non-sparing MVR surgery and mural leaflet and subvalvular apparatus sparing MVR surgery and remarkably improve heart functions for patients with Mitral Valve disease, but mural leaflet and subvalvular apparatus sparing MVR surgery has a significant superiority on the long-term improvement of heart functions then the traditional non-sparing MVR surgery, which is the reason for our hospital to always promote this procedure method for single MVR surgery. |
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