Long-term Results of Mitral Valve Surgery in Patients with Severe Pulmonary Hypertension

Cámara, María Luisa de la; Arı́s, Anna; Padró, José M.; Caralps, José M.

doi:10.1016/s0003-4975(10)62423-x

Cited by 41 publications

(25 citation statements)

References 19 publications

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“…Patients undergoing surgery are for the majority in stage II of the NYHA (76.47% and 69.69% in group A and B respectively); In the other series, patients are in stage III or IV [11,16,[20][21][22]. Postoperatively, it is interesting to report an improvement in the quality of life; 68.36% and 73.19% of patients in group A and B respectively were in stage I of NYHA (P<0.05 for both groups).…”

Section: Parametersmentioning

confidence: 89%

“…Until now, there is no consensus in the literature on the results after surgery for this category of patients; Some studies have associated PAH with a poor outcome and an estimated high mortality rate of 31% [1], which has led some authors to consider PAH as an absolute contraindication to MVR [5][6][7][8][9], while others do not fully agree and argue that severe PAH does not imply a greater surgical risk [10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…Group A Group A P (Preoperative) (Control) Citation Our population is young and predominantly female; the young age of the patients is explained by the rheumatic origin of valvulopathy, which is supported by the various publications [11,16,20,21].…”

Section: Parametersmentioning

confidence: 91%

“…Camara [20] found that PAPS regressed from 101 mmHg ± 22.4 mmHg to 40.5 mmHg ± 7.5 mmHg postoperatively. Cesnjevar [16] studied for a period of 30 years, 382 patients in severe PAH.…”

Section: Parametersmentioning

confidence: 97%

“…The correction of the tricuspid insufficiency (TI) suppresses the preload of the RV and thus prevents the occurrence of a RV dysfunction. In the literature, the correction of the tricuspid leak was noted by several authors: the correction of tricuspid was performed in 66.66% of patients in the "severe PAH" group compared to 36.66% in the " moderate PAH "; TI was corrected in the other series in 87.5% [21] and in 11% [20].…”

Section: Parametersmentioning

confidence: 98%

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Results of Mitral Valve Surgery with Pulmonary Arterial Hypertension: Analysis of a Retrospective Study

Bendjaballah¹,

Lakehal²,

Aimar³

et al. 2017

J Cardiovasc Dis Diagn

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Section: Parametersmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Parametersmentioning

confidence: 91%

“…Camara [20] found that PAPS regressed from 101 mmHg ± 22.4 mmHg to 40.5 mmHg ± 7.5 mmHg postoperatively. Cesnjevar [16] studied for a period of 30 years, 382 patients in severe PAH.…”

Section: Parametersmentioning

confidence: 97%

Section: Parametersmentioning

confidence: 98%

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Results of Mitral Valve Surgery with Pulmonary Arterial Hypertension: Analysis of a Retrospective Study

Bendjaballah¹,

Lakehal²,

Aimar³

et al. 2017

J Cardiovasc Dis Diagn

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Balloon mitral valvotomy in patients with systemic and suprasystemic pulmonary artery pressures

Bahl

Chandra

et al. 1995

Cathet. Cardiovasc. Diagn.

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Mitral stenosis with severe pulmonary artery hypertension constitutes a high risk subset for surgical commissurotomy or valve replacement. Balloon mitral valvotomy has been proposed as a technique for treating high risk surgical patients with mitral stenosis. The efficacy of this technique in patients with severe pulmonary artery hypertension, however, has not been fully evaluated. Percutaneous transvenous mitral commissurotomy (PTMC) was performed in 450 consecutive patients. Of these, forty-five (10%) patients had systemic or suprasystemic systolic pulmonary artery pressures (110 +/- 20, range 96 to 170 mm Hg). The baseline characteristics and immediate hemodynamic results of these 45 patients with systemic/suprasystemic systolic pulmonary artery pressures (group I) were analysed and compared with those of 405 patients with subsystemic systolic pulmonary artery pressures (group II). Patients in group I were more symptomatic (New York Heart Association functional class > or = III, 96 vs. 55%, P < 0.001) and had severe subvalvular fibrosis (mitral subvalvular distance ratio [MSDR], 0.14 +/- 0.04 vs. 0.22 +/- 0.04, P < 0.01). Before PTMC, mean transmitral gradient was higher (34 +/- 8 vs. 25 +/- 4 mm Hg, P < 0.02) and mitral valve area smaller (0.5 +/- 0.3 vs. 0.9 +/- 0.4 cm2, P < 0.02) in group I patients, who also had higher pulmonary vascular resistance (16 +/- 5 vs. 9 +/- 5 U, P < 0.005). After PTMC final mean transmitral gradients (7 +/- 3 vs. 5 +/- 3 mm Hg) and mitral valve areas (1.9 +/- 0.4 vs. 2.0 +/- 0.4 cm2) were similar in both groups (P = NS). Group I patients had a greater decrease in pulmonary artery pressures (34 +/- 4 vs. 25 +/- 2%, P < 0.05) but final systolic pulmonary artery pressures (82 +/- 20 vs. 50 +/- 14 mm Hg) and pulmonary vascular resistance (12 +/- 4 vs. 6 +/- 4 U) remained significantly higher in this group (P < 0.005). Thus, in patients with severe pulmonary artery hypertension, PTMC is a safe and effective technique providing good immediate hemodynamic results.

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Rest and exercise hemodynamics before and after valve replacement‐A combined doppler/catheter study

Nellessen

Inselmann

Ludwig

et al. 2000

Clinical Cardiology

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Long-term Results of Mitral Valve Surgery in Patients with Severe Pulmonary Hypertension

Cited by 41 publications

References 19 publications

Results of Mitral Valve Surgery with Pulmonary Arterial Hypertension: Analysis of a Retrospective Study

Results of Mitral Valve Surgery with Pulmonary Arterial Hypertension: Analysis of a Retrospective Study

Balloon mitral valvotomy in patients with systemic and suprasystemic pulmonary artery pressures

Rest and exercise hemodynamics before and after valve replacement‐A combined doppler/catheter study

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