A total of 133 consecutive patients with chronic rheumatic mitral incom­petence were operated upon with mi­tral valve replacement (MVR) in Car­die-Thoracic Surgery Department at Mansoura University Hospitals. Sev­enty-seven patients (57.9%) were fe­males and 56 (42.1%) were males, with age ranging from 16 to 41 years (mean 28.6 ± 5.3 years). Patients were studed preoperatively, early postoperatively (within three months), and at the most recent follow-up (mean of 40.3 months).
Seventy-one patients (53.4%) un­derwent conventional MVR (group I), and 62 (46.6%) underwent MVR with chorda! preservation (group II). Pre­operatively, there were no difference among both groups in age, gender,
NYHA (New York Heart Association) functional class, ejection fraction (EF), fractional shortening (FS), left ventric­ular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and left atrial diameter (LAD). There were four perioperative deaths (5.6%) and six late deaths among the 71 patients with conven­tional MVR, while in chordal preserva­tion patients there were two perioper­ative deaths and three late deaths. At 5 years, the cumulative proportion survival for group I was 83.5% and for group II was 91.5% (P = 0.03 and Log Rank = 4.31). All preoperative param­eters showed better improvement as measured early and at mid-term post­operatively in group II with statistically significant differences than in group I.