Background: Mitral valve replacement (MVR) with chordal sparing could improve
ventricular function in patients with mitral regurgitation. This study aimed to
compare the outcomes of prosthetic MVR with and without chordae tendineae
sparing.
Methods: This prospective, single-blinded, randomized study was executed on 60
patients undergoing prosthetic MVR with or without chordae tendineae sparing.
Patients were divided into two equal groups: Group A (n= 30) included patients who
underwent MVR with complete chordae tendineae sparing, and Group B (n= 30)
included patients who underwent mitral valve replacement without chordae
tendineae sparing.
Results: Patients who underwent chordae tendineae sparing demonstrated
significantly lower total bypass time (median = 67 vs. 110 min, P < 0.001), total crossclamp time (median = 40 vs. 80 min, P < 0.001), inotropic support (30% vs. 96.7%, P
< 0.001), and arrhythmia (6.7% vs. 86.7%, P < 0.001) than those who did not undergo
chordal sparing. Additionally, patients who underwent sparing demonstrated a
significantly lower 6-month left ventricle end-systolic diameter (3 ±0.8 vs. 3.9 ±0.5
cm, P < 0.001), 6-month left ventricle end-diastolic diameter (4.4 ±0.7 vs. 5.3 ±0.5
cm, P < 0.001), 3-month left atrium diameter (4.5 ±0.8 vs. 5.1 ±0.6 cm, P < 0.001),
and 6-month left atrium diameter (4.3 ±0.8 vs. 5.4 ±0.6 cm, P < 0.001).