Continuous Suture Technique for Isolated Mitral Valve Replacement - A Prospective Postoperative Analysis

BackgroundThe deleterious effects of cardiopulmonary bypass (CPB) are well known. Techniques to reduce the duration of CPB without compromising patient’s safety have been evolving. One such technique is the use of continuous suture technique for mitral valve replacement (MVR). In our study we have analyzed postoperative intensive care unit (ICU) course, morbidity and mortality in patients undergoing isolated MVR with continuous suture technique.MethodsFrom August 2011 through September 2012, 71 patients underwent isolated MVR with continuous suture technique. The study was prospective, and the database maintained by medical record section and phone contacts with patients. After discharge, patients were followed up clinically on day-7, & 1, 3 and 6 months. Echocardiography was done at 1 & 6 months.The statistical analysis was done using SPSS-15 software. The test used were Chi-square test, Student ‘t’test and ANOVA (Analysis Of Variance) test. ResultsAverage CPB time was 50.73+12.48 minutes and mean aortic cross-clamp time was 29.86+8.81 minutes. During ICU course, significant decrease in inotropic support (p=0.004), ventilator time (p=0.037), mediastinal drainage (p<0.001) and shorter ICU stay (p<0.001) were associated with decrease in CPB time. Mediastinal drainage averaged 258.31 ± 172.53 ml whereas 0.94 ± 0.843 units of packed red blood cells were transfused. Incidence of paravalvular leak was 4.2%. There were no incidences of suture breakage or prosthetic valve dehiscence. There was single peri-operative mortality resulting from fatal cerebral thromboembolism.ConclusionImproved post-operative recovery with comparable morbidity and mortality and cost effectiveness mandates use of continuous suture technique for MVR.