A Multi Center Experience: Is Valve Replacement Safe for Patients with Hugely Dilated Left Ventricle?

Background: Dilated left ventricle occurs in chronic aortic and mitral regurgitations. We describe the early outcome of mitral and aortic valve replacement for patients with severely dilated left ventricle in different surgical interventions. Methods: From March 2014 to December 2018, 620 patients with left ventricular end-diastolic diameter (LVEDD) of ≥ 70 mm underwent valve replacement procedures in 8 cardiac surgery centers in Egypt. One hundred ninety four cases (31.3%) underwent aortic valve replacement, 173 cases (27.9%) underwent mitral valve replacement, 123 cases (19.9%) underwent double valve replacement, 59 cases (9.5%) underwent double valve replacement with either tricuspid valve repair or replacement, 33 cases (5.3%) underwent mitral valve replacement with either tricuspid valve repair or replacement, 20 cases (3.2%) underwent mitral valve replacement with CABG, 10 cases (1.6%) underwent aortic valve replacement with CABG, while 8 cases (1.3%) underwent aortic valve replacement with ascending aortic aneurysm repair. Results: Four patients (0.6%) developed new postoperative renal failure, which required dialysis. Twenty-nine patients (4.7%) required reoperation for bleeding. One patient (0.2 %) developed sternal dehiscence. Five patients (0.8%) postoperatively developed stroke. Twenty-five patients (4%) died, and the main causes of death were low cardiac output and sepsis with eventual multi-organ failure. Conclusion: Valve replacement in patients with hugely dilated left ventricle are safe operations with satisfactory outcomes even if combined with other procedures, especially with proper preoperative preparation, intraoperative preservation of posterior mitral leaflet, and meticulous postoperative follow up in the surgical ICU.

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P1585Long-term tricuspid regurgitation progression in patients undergoing combined mitral valve replacement surgery and tricuspid valve repair

European Heart Journal ◽

10.1093/eurheartj/ehy565.p1585 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

O Itzhaki Ben Zadok ◽

R Sharony ◽

M Vaturi ◽

Y Shapira ◽

T Bental ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Replacement Surgery ◽

Valve Replacement Surgery

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Retrospective Study of the Outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair in Ain Shams University

QJM ◽

10.1093/qjmed/hcaa042.010 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A M A Elfeky ◽

M M A Fadala ◽

O A Abdelhameed ◽

R M R Khorshid

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Tricuspid Valve ◽

Mitral Valve Disease ◽

Valve Disease ◽

Morbidity And Mortality ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Number Of Patients

Abstract Background Rheumatic mitral valvular disease is more common than degenerative mitral valve disease. Mitral valve repair is not possible in large number of patients because of rheumatic cicatrized subvalvular mitral valve disease. The prosthetic mitral valve replacement is commonly performed in our center. Objective The aim of the study was to evaluate and assess the short outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair. Patients and Methods This study was done in department of Cardiothoracic surgery, Faculty of Medicine at Ain Shams university, after approval of the local ethical committee from 2015 to 2016.The inclusion criteria includes All gender, All age, Primary Mitral valve replacement for severe Mitral valve disease of Rheumatic origin with or without Tricuspid Valve Repair and Primary Mitral valve replacement for severe Mitral valve disease of Degenerative origin with or without Tricuspid Valve Repair and the exclusion criteria includes concomitant coronary artery bypass graft surgery or other cardiac operations or infective endocarditis and Patients with chronic liver, kidney and parenchymal pulmonary disease. Results This study included one hundred and seventy- seven (177) patients; One hundred and thirty one (131) patients did Mitral Valve Replacement without Tricuspid valve Repair, Fourty six (46) patients did Mitral valve Replacement with Tricuspid valve Repair and the outcome was Mortality (3.9%), Reoperaion (5.08%), Stroke (0. 56%), Re-Intubation (1.13%) and Re-Admission to ICU (1.69%) Conclusion The Reoperation has a direct relation and effect on the Mortality,Prolonged bypass time independently predicts postoperative morbidity and mortality and Prolonged aortic cross-clamp time significantly correlates with major post-operative morbidity and mortality.

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