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.