ijas

International Journal Of Advances In Surgery


ISSN (O) : 2663 - 046X

A CrossRef Indexed Journal

DOI : 10.34300/26630451

ISSN (P) : 2663 - 0451

IC VALUE : 89.54


Research Paper

Outcomes of complete mitral valve excision and replacement with Tilting disc (TTk chitra) valve for Rheumatic Mitral Valve Stenosis.

Dr. Venkata Vijay K, Dr Vivekanand Y, Dr. Rajitha Nnl, Dr. Deepak. T, Dr . Renuka Devi P

Abstract :

Mitral valve disease is one of the earliest disease of heart and rheumatic mitral valve disease is one of the first discovered in the world dated back to 19 century .Rheumatic heart disease is declining in other countries but still prevalent in rural part of india especially in lower economic group. In our hospital we have operated 50 cases of rheumatic mitral stenosis for whom MVR with tilting disc (TTK chitra valve) was done. Most of the mitral valves cases have MV score >12 and sub valvular apparatus was severely effected.In all the cases we have operated , we have excised complete valve and no posterior leaflet preservation or chordal tethering and repair was done.OBJECTIVES OF STUDY1. To study Mitral valve replacement out comes with Tilting disc TTK chitra valve and to compare pre and post operative valve gradient across tilting disc prosthetic valves and also study LV dimensions pre and post MV replacement and to study EF pre and post valve replacement and complications arising from posterior leaflet excision.MATERIALS AND METHODS50 Patients with CRHD with severe Mitral Stenosis have been taken up for study who were operated in this department from may 2016 to april 2019.All the patients are evaluated with 2D echo, ECG and CAG ( when they are >35 year RESULTSOut of 50 patients operated in our hospital 34 are females i.e, 68% of the patients and 16 patients are males i.e,32%.As per the age 20 patients are between 41-50yrs of age i.e 40% belong to 41-50yrs of age and 39 patients are below 50yrs i.e 78% of patients are below 50years and 4% are below 20 years and 22% are above 50 years.As per the combined age and sex ratio also both males and females most MS presumed below 50 years only. As per the valve area most common valve by preoperative echo is 66% are below and equal to 1 sq.cm by PHTs and planimetry.60% of patients have preoperative ejection fraction of more than 55% and less than 10% are between 36-40%.Preoperatively 40% of the patients have severe PAH 30% of patients have moderate PAH and 30% of patients had mild PAH. All these patients have been operated for mitral valve where posterior leaflet has been excised and no sub valvular apparatus has been conserved and no chordal repair has done but apparently no postoperative LV dysfunction was found in these patients.All these patient have taken up for mitral valve replacement and TTK CHITRA valve between 27 and 31 were used.In 70% of patients 29and 31 TTK CHITRA valve was used.Present study is based on echocardiographic analysis of the pre operative mean gradient across mitral valve and post operative mean gradient across mitral valve which shows a considerable, comparable and acceptable mean gradient post operatively.Conclusionwhen ever rheumatic mitral stenosis is present - complete valve can be reasonably excised with out even sparing or preserving sub valvular apparatus and it doesnt effect the ejection fraction and left ventricular function.Native tilting disc valve ie TTK Chitra valve can be safely used and gives comparable results with the recent generation valves,.better outcomes are encountered with 29 mm size and above size valves.Pulmonary artery hypertension decreases significantly if mitral stenosis is operated regardless the advancement of disease process.there is no significiant change in left ventricular parameters and pre and post operatively ejection fraction remained same


Keywords :

tilting disc (TTK chitra valve) Mitral valve disease  


Cite This Article:

OUTCOMES OF COMPLETE MITRAL VALVE EXCISION AND REPLACEMENT WITH TILTING DISC (TTK CHITRA) VALVE FOR RHEUMATIC MITRAL VALVE STENOSIS., Dr. Venkata Vijay K, Dr Vivekanand Y, Dr. Rajitha NNL, Dr. Deepak.T, Dr . Renuka Devi P, INTERNATIONAL JOURNAL OF ADVANCED MEDICINE : Volume-2 | Issue-4 | July-2018

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