Analysis of Preoperative and Postoperative Pulmonary Hypertension
Following Mitral Valve Replacement for Rheumatic Mitral Valvular Heart
Disease -- An Institutional study from a Tertiary Care Hospital
Abstract
Background: Pulmonary Hypertension in mitral valvular heart disease
leads to various adverse outcome following surgical treatment of this
condition. In majority of the patients this Pulmonary Hypertension is
reversible following surgery. The objective of this study is to assess
the outcome of changes in Severe Pulmonary Hypertension after Mitral
Valve Replacement during the follow up with postop Echocardiogram.
Patients and methods: In all our 265 patients who underwent Mitral Valve
Replacement Surgery (MVR) for Mitral valvular heart disease with
pulmonary hypertension, females 111/195(56.9%) outnumbered the males in
this study. 195 among 265 cases had severe PHT. MVR was done with
cardiopulmonary bypass using St Jude’s medical valve. Results: Despite
the high operative mortality in most series of MVR in patients with
severe PHT, a striking improvement in survival was noted in the study
with 5.3% mortality rate.A sudden drop of PHT is not observed in our
study. The fall was found to be gradual and significant over follow up
and the maximum reduction was at 1-3 months post operatively.
Conclusion: It is concluded that MVR reduces PHT in a gradual way and
the mortality rate is also minimum in severe PHT patients. MVR thereby
is an effective invasive procedure for the management of patients with
severe mitral valve disease and PHT. Keywords: Severe Pulmonary
Hypertension, mitral valvular disease, mitral valve replacement,
Pulmonary artery pressure, Rheumatic Heart Disease