Mitral Valve Replacement With Preservation Of The Subvalvular Apparatus

Despite the feet that mitral valve repair has become the most common approach in the treatment of mitral valve disease, particularly mitral regurgitation, prosthetic mitral valve replacement remains a standard procedure in cardiac surgery patients. After initial controversies regarding the importance of preservation of the subvalvular apparatus, it is today common sense that mitral valve replacement with partial or complete preservation of subvalvular structures is associated with an improved outcome. This article is in- tended to provide information about general techniques of mitral valve replacement, to describe the importance of the subvaivuiar structures for left ventricular function, and to discuss different approaches for the preservation of the subvaivuiar apparatus.