The Effect of Preoperative Pulmonary Arterial Pressure and Right Ventricular Function on the Changes in Right Ventricular Function after Mitral Valve Replacement

2001 ◽  
Vol 40 (1) ◽  
pp. 16
Author(s):  
Sang Hwa Kang ◽  
Young Lan Kwak ◽  
Yon Hee Shim ◽  
Young Jun Oh ◽  
Sang Boem Nam ◽  
...  
2020 ◽  
pp. 43-46
Author(s):  
Debashis Karmokar ◽  
Pinaki Majumdar ◽  
Manjushree Ray ◽  
Asim Kumar Kundu

Objective:Right ventricular dysfunction constitutes a major risk factor for patients suffering from degenerative mitral valve disease. The objective of this study was to assess right ventricular function by echocardiography and to detect role of right ventricular functions in prediction of outcome following mitral valve replacement operation in patients with rheumatic heart disease involving mitral valve. Methods:Transthoracic 3D echocardiography was done in 52 patients posted for mitral valve replacement surgery. Right ventricular function was analyzed by measuring fractional area change (FAC) of right ventricle, tethering distance and, tricuspid annular plane systolic excursion (TAPSE). Tricuspid regurgitation was graded 0 to 4. Based on echocardiographic ndings of right ventricle, patients were allocated in two groups; Group A (normal right ventricular function) and Group B (poor right ventricular function). After surgery, incidence of complications such as; low cardiac output syndrome, refractory arrhythmia and, sepsis were compared in two group. Results: Incidence of postoperative complication such as low cardiac output syndrome and sepsis was signicantly more in patients with poor right ventricular function. Right ventricular variables, FAC <35%, TAPSE <17 mm and tethering distance > 8 mm are independent predictors of postoperative complications. Tricuspid valve was repaired in patients with grade 3 and 4 regurgitation. Therefore cardiopulmonary bypass time was signicantly more in patients with grade 3 and 4 TR (84.42±69.77 min) (p<0.01). Duration of intensive care support was also signicantly more in patients with poor right ventricular function (p<0.001) Conclusion: To predict possible complications and outcome following mitral valve replacement surgery, right ventricular functions should be thoroughly assessed by 3D echocardiography


Vascular ◽  
2017 ◽  
Vol 26 (2) ◽  
pp. 183-188
Author(s):  
Mustafa Aldemir ◽  
Sadık Volkan Emren ◽  
Çınar Balçık ◽  
Ersel Onrat ◽  
Merve Gürsoy

Objectives Pulmonary hypertension with heart failure is related to venous insufficiency. However, there is no clear data whether pulmonary arterial hypertension with preserved right ventricular function cause venous insufficiency. In this study, we aim to investigate the relation between pulmonary arterial pressure with venous insufficiency in pulmonary arterial hypertension patients with preserved right ventricular function. Methods Between January 2012 and October 2014, 38 patients with a diagnosis of pulmonary arterial hypertension and 47 control group patients were included. Venous disability score and venous segmental disease score of both groups were calculated in order to measure venous insufficiency. The relationship between venous disability score and venous segmental disease scores and mean pulmonary arterial pressure and World Heart Organization functional capacity was examined. Results Total venous segmental disease score (5 ± 3.9 vs. 2 ± 1.8 p < 0.001), right venous segmental disease score (2.6 ± 2.2 vs. 1 ± 0.9 p < 0.001), left venous segmental disease score (2.4 ± 2.2 vs. 1 ± 0.9 p < 0.001), and venous disability scores (2.2 ±1 vs. 1.6 ± 0.7 p < 0.001) of patients with pulmonary arterial hypertension were higher than the control group. While the total venous segmental disease score was highly related to mean pulmonary arterial pressure (r = 0.829, p < 0.001), the venous disability score was only weakly related (r = 0.343, p = 0.037). Total venous segmental disease score (r = 0.606, p < 0.001) and venous disability scores (r = 0.601, p < 0.001) were moderately related with World Health Organization functional capacity intensity. Conclusions The degree of venous insufficiency increase in accordance with the mean pulmonary arterial pressure even in patients with preserved right ventricular function.


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