Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Assessment of left ventricular geometry and function using Echocardiographic studies carry a higher rate of inaccurate values specially in the presence of mitral valve disease. Three-dimensional left ventricular geometric evaluation using MRI provides more accurate details about left ventricular geometry and function Objectives: To evaluate the beneficial effect of partial and complete preservation of papillary annular continuity, using CMR as a novel modality of comparison to evaluate the postoperative left ventricular function and geometry. Patient & methods: In our study, 32 Patients, males or females, different age group, with predominant mitral regurgitation, indicated for mitral valve replacement, mitral valve replacement was done. Patients were randomized in two groups , where posterior preservation was in group I, and both leaflet preservation was in group II. The study was done at different institutions, with the same group of surgeons, in the period between May 2015 and Feb 2017. All patients went through preoperative, operative& early postoperative evaluation. Results: According to our knowledge this is the first study in Egypt to use CMR in evaluating the effect of mitral valve replacement on cardiac function. Postoperative evaluation demonstrated a significant improvement in left ventricular function and dimensions in both groups using echocardiography or CMR. But the study also failed to quantify significant superiority of either technique in our selected patient groups.This was consistent with many trails done before using echocardiography only

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