Early Patient Outcome and Left Ventricular Function After Mitral Valve Replacement Using a Tilting Disc Mechanical Valve With Total Preservation of Mitral Valvular Apparatus

Cureus. 2024 Nov 30;16(11):e74823. doi: 10.7759/cureus.74823. eCollection 2024 Nov.

Abstract

Introduction The study aimed to retrospectively evaluate the early patient outcome and left ventricular function after mitral valve replacement with a tilting disc valve and total preservation. Patients and methods This retrospective observational study includes patients who underwent mitral valve replacement using a tilting disc valve with total preservation of mitral valvular and subvalvular apparatus from July 2021 to August 2022 at a single center. Results The data were reviewed retrospectively for age, sex, comorbidities, operating time, aortic cross-clamp time, cardiopulmonary bypass time, preoperative and postoperative left ventricular ejection fraction, mean gradient across the mitral valve, left ventricular diameter, left atrial size, atrial fibrillation, complications, mortality, and early patient outcome. Echocardiographic and clinical data were compared for the preoperative and postoperative periods. A significant difference in the preoperative and postoperative left atrial size, pulmonary arterial pressure, New York Heart Association class, and mean gradient across the mitral valve was found. However, the difference between the preoperative and postoperative ejection fraction and left ventricular diameter in systole and diastole was not significant. Conclusion Early patient outcome after mitral valve replacement with a tilting disc valve and total preservation of mitral valvular apparatus gives good results with minimal morbidity and mortality. Favorable patient outcomes in this study lay to rest any skepticism regarding total preservation while using a tilting disc valve. The technique of total preservation is safe while using a tilting disc valve, and it helps in the preservation of the left ventricular ejection fraction and gives a low gradient across the valve.

Keywords: mechanical tilting disc valve; mitral valve replacement; mitral valvular apparatus; total preservation; ttk chitra prosthetic valve.