AIM To investigate the effect of preserving the posterior and subvalvular structures on myocardial strain in patients with rheumatic mitral stenosis (RMS).
METHODS RMS patients (106 cases) admitted to Qingyuan People's Hospital from January 2014 to May 2022 were selected as the research subjects, and according to whether the posterior valve and subvalvular structures were preserved during the operation, they were divided into preservation group (56 cases) and non preservation group (50 cases). The clinical data, ultrasound parameters, myocardial strain and postoperative complications of the two groups were compared and analyzed.
RESULTS Compared with the non preservation group, the preservation group had shorter ICU retention time, ventilator assistance time and hospital stay (all P<0.01). One month after operation, compared with the non preservation group, the left ventricular end diastolic diameter (LVEDD) and left ventricular end diastolic volume (LVEDV) of the preservation group were lower (all P<0.01), and the left ventricular short axis shortening rate (LVFS) (P<0.05) and left ventricular ejection fraction (LVEF) (P<0.01) were higher. Compared with the non preservation group, the left ventricular peak systolic strain (Ss) (basal segment P<0.05, middle segment P<0.01) and systolic peak strain rate (SRs) (basal segment P<0.01, middle segment P<0.05) of the preservation group were higher 3 months after operation. Compared with that before operation, the left ventricular myocardial Ss of the patients in the non preservation group were lower 1 month after operation (all P<0.01), the left ventricular myocardial Ss and SRs of the basal and middle segments were lower 1 month after operation in the preservation group (all P<0.01), and the left ventricular myocardial Ss of the basal and middle segments were higher 3 months after operation (all P<0.05), and the left ventricular myocardial SRs of the basal and middle segments were higher (all P<0.01). Compared with 1 month after operation, the left ventricular myocardial Ss and SRs of patients in the non preservation group were higher 3 months after operation (all P<0.05), and those in the preservation group were higher 3 months after operation (all P<0.01). Compared with the non preservation group, the preservation group had a lower probability of complications 1 month after surgery (P<0.05).
CONCLUSION The retention time in ICU, ventilator assistance time and hospitalization time of RMS patients with preserved posterior valve and subvalvular structures were significantly shortened, which was helpful for postoperative recovery of cardiac function and reduction of complications, and the clinical effect was significant.
DownLoad: