Early Beneficial Effect of Preservation of Papillo-Annular Continuity in Mitral Valve Replacement on Left Ventricular Function
Dronamraju Dilip FRCS, Abha Chandra MCh, Durgaprasad Rajashekhar DM, Manoj Padmanabhan MCh

Left ventricular dimensions and left ventricular ejection fraction (LVEF) were studied before and 3-6 months after mitral valve replacement (MVR) with and without preservation of papillo-annular continuity. Patients with preserved papillo-annular continuity showed marked clinical improvement, with significant decrease in the left atrial dimensions (LAD), left ventricular end-diastolic (LVEDD) and left ventricular end-systolic dimensions (LVESD), and improvement in LVEF, irrespective of lesion type. In contrast, patients who underwent conventional MVR showed increased LAD, LVEDD and LVESD, and significantly reduced LVEF. This study highlights that preservation of mitral annulo-papillary continuity during MVR leads to better preservation of left ventricular (LV) function. The results further suggest that chordal preservation is particularly important in patients with mitral stenosis who have depressed LV systolic function.