scholarly journals Improvement of exercise capacity after early phase II cardiac rehabilitation in patients who undergo rheumatic mitral valve surgery

2020 ◽  
Author(s):  
Ade Meidian Ambari ◽  
Budhi Setianto ◽  
Anwar Santoso ◽  
Basuni Radi ◽  
Bambang Dwiputra ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Phase Ii ◽  
Mitral Stenosis ◽  
Early Phase ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Rheumatic Mitral Stenosis ◽  
Rheumatic Heart

Background: Rheumatic heart disease still become a major concern in developing countries. Recent studies showed the benefits of early phase II cardiac rehabilitation (CR) on improving the exercise capacity but the evidence in patients after rheumatic mitral valve surgery due to rheumatic heart disease is limited. This study aims to investigate the effects of early phase II CR program on increasing exercise capacity in the rheumatic mitral valve surgery patients. Methods: This is a cohort retrospective study. A review of medical records identified 254 patients who underwent early phase II CR after rheumatic mitral valve  surgery between July 2009 – June 2019. Effects of CR was assessed by 6 Minutes Walking Distance (6MWD) pre and post early phase II CR and peak oxygen uptake (VO2 peak) calculated by Cahallin formula. In this study, we observed and analyzed the increasing of 6MWD and VO2 peak. Results: Our findings showed that 6MWD and VO2 peak increased significantly in these patients after early phase II CR program (p = 0.001). Mean of 6MWD increased from 316.3 ± 71.7 meters to 378.6 ± 60.3 meters and VO2 peak increased from 7.7 ±2.4 mL/kg/min to 8.9 ± 2.2 mL/kg/min. The mean difference of 6MWD was 62.3 meters and VO2 peak was 1.2 mL/kg/min. There was a strong correlation between VO2 peak and 6MWD (r = 71%; R2 = 51%; p = 0.001). Conclusion: Early phase II CR in patients with Rheumatic Mitral Stenosis after mitral valve surgery improved the exercise capacity. Based on 6MWD, we can predict the value of VO2 peak patients with rheumatic mitral stenosis surgery patients.   Keywords: Cardiac rehabilitation, rheumatic mitral stenosis, 6MWD, VO2 peak

scholarly journals Prognostic Value of Late Gadolinium Enhancement in Postoperative Morbidity following Mitral Valve Surgery in Rheumatic Mitral Stenosis

2019 ◽  
Vol 28 (04) ◽  
pp. 237-244
Author(s):  
Teuku Muhammad Haykal Putra ◽  
Renan Sukmawan ◽  
Elen Elen ◽  
Celly A. Atmadikoesoemah ◽  
Dwita Rian Desandri ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Late Gadolinium Enhancement ◽  
Mitral Valve ◽  
Myocardial Fibrosis ◽  
Mitral Stenosis ◽  
Postoperative Morbidity ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Gadolinium Enhancement ◽  
Rheumatic Mitral Stenosis

Myocardial fibrosis in rheumatic mitral stenosis (MS) is caused by chronic inflammatory process. Its occurrence may lead to hemodynamic problems, especially after cardiac surgery. Myocardial fibrosis predicts worse morbidity after cardiac surgery, notably in coronary heart disease and aortic valve abnormalities. However, this issue has not been explored yet among patients with rheumatic MS.The aim of the study was to investigate prognostic impact of myocardial fibrosis to postoperative morbidity after mitral valve surgery in patients with rheumatic MS.This is a prospectively enrolled observational study of 47 consecutive rheumatic MS patients. All patients had preoperative evaluation with cardiac magnetic resonance imaging (CMR) including late gadolinium enhancement (LGE) protocol for left ventricular myocardial fibrosis assessment prior to mitral valve surgery. All patients were followed during hospitalization period. Postoperative morbidities were defined as stroke, renal failure, and prolonged mechanical ventilation.This study involved 33 women (70.2%) and 14 men (29.8%) with a mean age of 46 ± 10 years. Preoperative myocardial fibrosis was identified in 43 patients (91.5%). Estimated fibrosis volume ranged from 0% to 12.8% (median 2.8%). Postoperative morbidities occurred in 11 patients (23.4%). Significant mean difference of myocardial fibrosis volume was observed between patients with and without morbidity after mitral valve surgery (5.97 ± 4.16% and 3.12 ± 2.62%, p = 0.04). This significant association was allegedly influenced by different postoperative hemodynamic changes between the two groups.More extensive myocardial fibrosis is associated with postoperative morbiditiy after mitral valve surgery in patients with rheumatic MS.

scholarly journals Atrial fibrillation and early clinical outcomes after mitral valve surgery in patients with rheumatic vs. non-rheumatic mitral stenosis

Heart Views ◽  
2012 ◽  
Vol 13 (4) ◽  
pp. 136 ◽  
Author(s):  
SJ Mirhosseini ◽  
Sadegh Ali-Hassan-Sayegh ◽  
Mehdi Hadadzadeh ◽  
S. M. Y Mostafavi Pour Manshadi ◽  
Nafiseh Naderi
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Clinical Outcomes ◽  
Mitral Stenosis ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Rheumatic Mitral Stenosis ◽  
Early Clinical Outcomes

scholarly journals Left Ventricular Dimension after Mitral Valve Surgery in Rheumatic Mitral Stenosis: the Impact of Myocardial Fibrosis

2020 ◽  
Author(s):  
Teuku Muhammad Haykal Putra ◽  
Renan Sukmawan ◽  
Dwita Rian Desandri ◽  
Celly A. Atmadikoesoemah ◽  
Elen Elen ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Myocardial Fibrosis ◽  
Mitral Stenosis ◽  
Mitral Valve Surgery ◽  
Left Ventricular ◽  
Valve Surgery ◽  
P Value ◽  
Rheumatic Mitral Stenosis ◽  
Dimensional Parameters ◽  
The Impact

Background: Patients with rheumatic mitral stenosis (MS) experience changes in left ventricular (LV) dimensions after mitral valve surgery. We sought to investigate changes in LV dimensional parameters after mitral valve surgery and find out whether the same changes occurred in different extents of myocardial fibrosis. Methods: This prospective observational study comprised 43 patients with rheumatic MS planned for mitral valve surgery between October 2017 and April 2018 in National Cardiovascular Center Harapan Kita (NCCHK) Jakarta. All the patients underwent cardiac magnetic resonance imaging based on the late gadolinium enhancement (LGE) protocol for myocardial fibrosis assessment prior to surgery. The patients were classified according to the estimated fibrosis volume considered to influence hemodynamic performance (myocardial fibrosis <5% and myocardial fibrosis ≥5%). Serial transthoracic echocardiographic examinations before and after surgery were performed to detect changes in LV dimensional parameters. Results: This study consisted of 31 (72.1%) women and 12 (27.9%) men at a mean age of 46±9 years. The LGE protocol revealed myocardial fibrosis of less than 5% in 32 (74.4%) patients. A significant increase was detected in the LV end-diastolic diameter postoperatively, specifically in the patients with myocardial fibrosis of less than 5% (44.0±4.8 mm vs 46.6±5.6 mm; P value=0.027). A similar significant increase was not found in the other group (45.0±6.6 mm vs 46.7±6.9 mm; P value=0.256). Other changes in echocardiographic parameters showed similar patterns in both groups. Conclusion: Our patients with rheumatic MS who had myocardial fibrosis of less than 5% demonstrated better improvements in terms of increased preload. Myocardial fibrosis of less than 5% is associated with more favorable improvements in LV geometry.

Exercise capacity differences between healthy adults and minimally invasive mitral valve surgery patients

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e1601-e1602
Author(s):  
Y. Wang ◽  
L. Guo ◽  
X. Zhang ◽  
G. Zhang ◽  
Z. Liu ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Exercise Capacity ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Healthy Adults

scholarly journals CLINICAL AND ECHOCARDIOGRAPHIC PREDICTORS OF EXERCISE CAPACITY FOLLOWING MITRAL VALVE SURGERY FOR MITRAL REGURGITATION

2016 ◽  
Vol 67 (13) ◽  
pp. 2220
Author(s):  
Nicholas M. Furiasse ◽  
Todd Kiefer ◽  
Sanjiv Shah ◽  
Bonnie Kane ◽  
Nishath Quader ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Exercise Capacity ◽  
Mitral Valve Surgery ◽  
Valve Surgery

Immediate outcome following valve surgery for rheumatic heart disease: the first local experience from Ethiopia

2020 ◽  
Vol 30 (9) ◽  
pp. 1281-1287
Author(s):  
Fekede A. Debel ◽  
Belete Zekarias ◽  
Tomasa Centella ◽  
Atnafu M. Tekleab
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Rheumatic Heart Disease ◽  
Surgical Outcome ◽  
Addis Ababa ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Mitral Valves ◽  
Excellent Outcome ◽  
Rheumatic Heart

AbstractBackground:Rheumatic heart disease is the most common cardiac diseases in developing countries including Ethiopia. The current study aimed to describe the immediate surgical outcome following valve surgery for rheumatic heart disease in Ethiopia.Methods:Data were collected through chart abstraction from two centres in Addis Ababa, Ethiopia: the Cardiac Center of Ethiopia and El Ouzier cardiac centre. Included were all patients who were operated for rheumatic valvular heart disease in the mentioned centres by local cardiac surgical team during the period from June 2017 to April 2020. Demographic and clinical characteristics of the study population at admission and within 30 days of the index cardiac surgery were collected. Statistical Package for Social Sciences version 20.0 for windows was used to analyse the data.Result:Of the 114 patients included in the study (median age 31 years with interquartile range of 23–40), 62 (54.4%) of them were female. Surgical procedures done were triple valve surgery 9 (7.9%) patients, mitral and tricuspid valves 26 (22.8%) patients, double-valve 16 (14.0%) patients, single-valve surgery 50.9% (11 aortic and 47 mitral valves) of patients, redo mitral valve surgery 3 (2.6%) patients, and left maze with mitral valve surgery 2 (1.8%) patients. Of the total, 103 (90.4%) of them had mitral valve surgery. Post-operatively, 5 (4.4%) patients died within 30 days following the index surgery.Conclusion:Immediate surgical outcome following valve surgery for rheumatic heart disease had excellent outcome in our setting. This evidence can be taken as a show of success in building local capacity to manage rheumatic heart disease surgically.

scholarly journals Pulmonary Function Changes Before and After Mitral Valve Surgery in Severe Mitral Stenosis

2018 ◽  
Vol 02 (02) ◽  
pp. 079-083
Author(s):  
Manoj Kumar Sahu ◽  
Mayank Yadav ◽  
Milind Padmakar Hote ◽  
Sarvesh Pal Singh ◽  
Shiv Kumar Choudhary
Keyword(s):  
Mitral Valve ◽  
Pulmonary Function ◽  
Mitral Stenosis ◽  
Pulmonary Function Tests ◽  
Nyha Class ◽  
Forced Expiratory Volume ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Female Ratio ◽  
Expiratory Flow

Abstract Objective This study was undertaken to assess the pulmonary functions in the patients with predominant severe mitral stenosis before corrective mitral valve surgery, then to reassess the same 6 months after surgery and compare them. Patients and Methods Fifty consecutive patients with predominant severe mitral stenosis undergoing mitral valve replacement surgery were included in this prospective observational study. This study was conducted from July 2016 till January 2018 after obtaining approval from the institute's ethics committee and written consent from all the participants. All the patients were evaluated clinically and divided according to New York Heart Association (NYHA) class symptomatology. Computed spirometric pulmonary function tests (PFTs) such as forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, forced expiratory flow (FEF) 25–75%, peak expiratory flow rate (PEFR), and maximum voluntary ventilation (MVV) were performed on each patient 1 day before and 6 months after surgery. Results Fifty study patients were analyzed, mean age was 38.4 ± 10.76 years (15–56 years), and male-to-female ratio was 1:1.38 (21 males and 29 females). NYHA class symptoms improved significantly in most of our patients after surgery (p < 0.01). PFTs such as FVC, FEV1, FEV1/FVC ratio, FEF 25–75%, and MVV showed significant improvement 6 months after surgery (p < 0.01). Though PEFR also improved compared with preoperative values, it was not significant statistically (p < 0.07). Conclusion This study showed that the lung functions are impaired in patients with severe mitral stenosis and improved significantly 6 months after surgery, which does not correlate well with the betterment of NYHA class.

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