Value of pulmonary artery pressure in predicting in-hospital and one-year mortality after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease: an observational study

The aim of this work was to investigate a role of endothelial dysfunction for development of pulmonary hypertension in young and middle-aged bronchial asthma (BA) patients. In total, 56 patients with mild and moderate persisting BA were examined. The endothelial function was assessed using nitrate levels in erythrocytes and plasma and L-arginin concentration in plasma. Endothelial dysfunction was more prominent in patients with moderate BA. Severity of endothelial dysfunction correlated to obstructive disorders. Plasma and erythrocytes nitrates and plasma L-arginin concentrations were lower in females than were in males and were lower in middle-aged patients compared to youngs. Endothelial dysfunction was more severe in patients with pulmonary hypertension than were patients with normal pulmonary artery pressure. Correlations were revealed between plasma level of nitrates and pulmonary artery pressure, plasma level of nitrates and the right ventricle size. Therefore, endothelial dysfunction could result in cardiovascular pathology in asthmatic patients.

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The effects of severe aortic stenosis and high pulmonary artery pressure on aortic valve replacement

World Journal of Cardiovascular Diseases ◽

10.4236/wjcd.2013.37067 ◽

2013 ◽

Vol 03 (07) ◽

pp. 428-432

Author(s):

Faruk Toktas ◽

Arif Gucu ◽

Gunduz Yumun ◽

Cuneyt Eris ◽

Serhat Yalcinkaya ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Stenosis ◽

Pulmonary Artery ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Pulmonary Artery Pressure ◽

Severe Aortic Stenosis ◽

Artery Pressure

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Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up

Journal of Clinical Medicine ◽

10.3390/jcm10173878 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3878

Author(s):

Lukas Weber ◽

Hans Rickli ◽

Philipp K. Haager ◽

Lucas Joerg ◽

Daniel Weilenmann ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Aortic Valve ◽

Pulmonary Artery ◽

Valve Replacement ◽

Pulmonary Artery Pressure ◽

Left Ventricular Ejection ◽

Aortic Valve Area ◽

Artery Pressure ◽

Valve Area

(1) Background: Pulmonary hypertension after aortic valve replacement (AVR; post-AVR PH) carries a poor prognosis. We assessed the pre-AVR hemodynamic characteristics of patients with versus without post-AVR PH. (2) Methods: We studied 205 patients (mean age 75 ± 10 years) with severe AS (indexed aortic valve area 0.42 ± 0.12 cm2/m2, left ventricular ejection fraction 58 ± 11%) undergoing right heart catheterization (RHC) prior to surgical (70%) or transcatheter (30%) AVR. Echocardiography to assess post-AVR PH, defined as estimated systolic pulmonary artery pressure > 45 mmHg, was performed after a median follow-up of 15 months. (3) Results: There were 83/205 (40%) patients with pre-AVR PH (defined as mean pulmonary artery pressure (mPAP) ≥ 25 mmHg by RHC), and 24/205 patients (12%) had post-AVR PH (by echocardiography). Among the patients with post-AVR PH, 21/24 (88%) had already had pre-AVR PH. Despite similar indexed aortic valve area, patients with post-AVR PH had higher mPAP, mean pulmonary artery wedge pressure (mPAWP) and pulmonary vascular resistance (PVR), and lower pulmonary artery capacitance (PAC) than patients without. (4) Conclusions: Patients presenting with PH roughly one year post-AVR already had worse hemodynamic profiles in the pre-AVR RHC compared to those without, being characterized by higher mPAP, mPAWP, and PVR, and lower PAC despite similar AS severity.

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Effect of peri-operative milrinone on pulmonary artery pressure in patients undergoing mitral valve replacement

Journal of Surgery and Medicine ◽

10.28982/josam.631161 ◽

2019 ◽

Author(s):

Ahmet Dolapoğlu ◽

Eyüp Avcı

Keyword(s):

Mitral Valve ◽

Pulmonary Artery ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Pulmonary Artery Pressure ◽

Artery Pressure

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Multicenter Analysis of Clinical Follow-Ups in Patients with a Star GK Cardiac Valve Replacement for More than One Year

The Heart Surgery Forum ◽

10.1532/hsf.1441 ◽

2016 ◽

Vol 19 (3) ◽

pp. 104

Author(s):

Mingwen Li ◽

Yingbin Xiao ◽

Daozhong Chen ◽

Liming Liu ◽

Liming Ma ◽

...

Keyword(s):

Valve Replacement ◽

Clinical Data ◽

Blood Component ◽

Left Heart Failure ◽

Replacement Surgery ◽

Low Incidence ◽

One Year ◽

Valve Model ◽

Valve Replacement Surgery

Background: Star GK valves were widely used in China, and we studied the clinical follow-up results of patients with Star GK valve implants for more than one year. Methods: Clinical data were collected from those patients who had Star GK valve implants for over one year. Patients were divided into three groups: (1) AVR group: received aortic valve replacement surgery. Based on the valve model this group was further sub-divided into two groups: 21A group, and 23A group; (2) MVR group: received mitral valve replacement surgery. Based on the valve model this group was further sub-divided into three groups: 25M group, 27M group, and 29M group; (3) DVR group: received combined replacement surgeries including AVR + MVR. According to postoperative follow-up time these patients were divided into two groups: 1-year group and 3-year group. Follow-up data were collected by telephone, outpatient visits, or correspondence. Clinical data were aggregated by professional data scientists to conduct independent analyses. Results: 959 patients were included in the study following Star GK valve implant. Follow-up after 1 year found that thrombosis occurred in 4 cases, hemorrhage in 15 cases, left heart failure in 13 cases, paravalvular leakage in 5 cases, and death due to cardiac causes in 2 cases. Conclusion: The long-term efficacy of Star GK valve implants was satisfactory with low incidence of valve-related complications, and following Star GK valve implant, valve and blood were highly compatible and blood component damage was minor. Very low incidence rate of thrombosis was observed following Star GK valve implant, however, attention should be paid to adjust the anticoagulation intensity.

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Effect of Nitroglycerin Inhalation on Patients with Pulmonary Hypertension Undergoing Mitral Valve Replacement Surgery

Anesthesiology ◽

10.1097/00000542-200310000-00017 ◽

2003 ◽

Vol 99 (4) ◽

pp. 855-858 ◽

Cited By ~ 28

Author(s):

Nurgul Yurtseven ◽

Pelin Karaca ◽

Mehmet Kaplan ◽

Vedat Ozkul ◽

Abdullah K. Tuygun ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Mean Arterial Pressure ◽

Mitral Valve ◽

Pulmonary Artery ◽

Arterial Pressure ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Vascular Resistance ◽

Replacement Surgery ◽

Valve Replacement Surgery

Background The aim of this study was to investigate the postoperative hemodynamic effects of nitroglycerin inhalation on patients with pulmonary hypertension undergoing mitral valve replacement surgery. Methods Twenty patients who underwent mitral valve replacement surgery were included in the study. In the surgical intensive care unit, at T0 (before the inhalation of nitroglycerin), basal systemic and pulmonary hemodynamics were recorded. Then, 2.5 microg x kg-1 x min-1 nitroglycerin liquid nebulized by a 2-l gas flow of 40% oxygen and air mixture was administered to the patients who were diagnosed as having pulmonary hypertension (mean pulmonary arterial pressures > 25 mmHg). The same parameters were measured at the first (T1), third (T2), and fifth (T3) hours after the beginning of this treatment and 1 h after the end of nitroglycerin inhalation (T4). Results There were no statistically significant differences at T0, T1, T2, T3, or T4 with respect to heart rate, mean arterial pressure, systemic vascular resistance, cardiac index, mixed venous oxygen saturation, arteriovenous oxygen content difference, or arterial carbon dioxide tension. However, mean pulmonary artery pressure, pulmonary vascular resistance, and intrapulmonary shunt fraction were significantly lower, and the arterial oxygen tension/fraction of inspired oxygen ratio was higher at T1, T2, and T3 when compared to that of T0 and T4. Conclusion The results suggest that nitroglycerin inhalation produces a significant reduction in both mean pulmonary artery pressure and pulmonary vascular resistance in patients after mitral valve operations without reducing mean arterial pressure and systemic vascular resistance. Therefore, it might be a safe and useful therapeutic intervention during the postoperative course.

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