Effects of Valve Diameter on LongTerm Left Ventricular Functions in Mitral Valve Replacement

Mert KESTELLİ, B. Hayrettin ŞİRİN, Rahmi ZEYBEK, Mansur ŞAĞBAN, *Nursen POSTACI, **Nagehan KARAHAN

İzmir Atatürk Devlet Hastanesi, Kalp ve Damar Cerrahisi Kliniği
^*İzmir Atatürk Devlet Hastanesi, Kardiyoloji Kliniği
^**İzmir Atatürk Devlet Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği

Normall, shortening of the minor (transverse) axis accounts %85-90 of the left ventricular stroke volume. The change in shapc and orifice area of mitral valve during systolic contraction has bccn shown. Large diameter mitral valves provide large orifice area with low diastolic gradient but may cause the limitation in the shortening of the minor axis during systole and led to a detcrioration in systolic functiotı. in this stduy, left ventricular functions of 12 patients treated with 29 mm, and 15 patients treated with 31 mm mitral valve replacement with Mcdtronic-Hall prosthetic valve were evaluated with two-dimensional echocardiographic techniquc in the late postopcrative period (postoperative 16-34 month).

There was no differcnce between two groups preoperatively. Jn the late postoperative period, ejection fraction (EF) was found significantly higher and end systolic volume index (ESVI) significantly lower in the 29 mm valve group (EF: %68±7 and %60.5±7; ESVI: 29.9+12.7 and 42.3+14.1 in 29 and 31 mm valve group respectivcly, p<0.05). Differences between enddiastolic volume index (EDVI) and stroke volume index (STKVI) were not found as significant statistically. in conclusion, large diameter mitral valve may have ncgative effcct on left ventricular systolic function.

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