Alterations in pulmonary artery pressure following mitral valve replacement [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2012; 40(3): 235-241 | DOI: 10.5543/tkda.2012.02328

Alterations in pulmonary artery pressure following mitral valve replacement

Gökhan Lafçı1, Adem İlkay Diken1, Hikmet Selçuk Gedik1, Kemal Korkmaz1, Fırat Özcan2, İrfan Taşoğlu1, Garip Altıntaş1, Kerim Çağlı1
1Türkiye Yüksek Ihtisas Hospital, Deparment of Cardiovascular Surgery, Ankara, Turkey
2Türkiye Yüksek Ihtisas Hospital, Deparment of Cardiology, Ankara, Turkey


OBJECTIVES
We sought to evaluate the early postoperative hemodynamics and clinical aspects in patients with moderate to severe pulmonary artery pressure (PAP) who underwent mitral valve replacement (MVR) due to isolated mitral valve stenosis.

STUDY DESIGN
Fifty patients (33 women, 17 men; mean age 45.8±11.2) were divided into two groups according to mean PAP levels (PAP <50 mmHg as Group I and PAP >50 mmHg as Group II). PAP and pulmonary capillary wedge pressure (PCWP) values were recorded using Swan-Ganz catheter just before the surgery in the operation theatre. These measurements were repeated after weaning from cardiopulmonary bypass, at 1, 12 and 24 hours. Intubation period in the intensive care unit, need for inotropic agents in the pre-and postoperative course, and mortality and morbidity data were also evaluated. Transthoracic echocardiography was used to measure PAP at the postoperative 24th hour and at the 2nd month after the surgery.

RESULTS
Mean PAP decreased significantly in both groups compared with basal levels. The regression was higher in Group II than Group I. Decrease in PCWP was more significant in Group II. PAP had decreased similarly in both groups according to the postoperative 24th hour echocardiographic evaluation; however, at the postoperative second month follow-up, the decrease in PAP was more significant in Group II.

CONCLUSION
Pulmonary arterial and left atrial pressures significantly decreased in the early periods when the stenosis was alleviated in the isolated mitral stenosis cases with moderate or high PAP levels. This study demonstrates the increased morbidity in patients with higher PAP levels undergoing surgery. It seems that moderate PAP levels do not have a negative influence on postoperative outcomes.

Keywords: Aortic valve stenosis, blood pressure, cardiac output; coronary disease/complications; heart catheterization; hypertension, pulmonary/etiology; mitral valve insufficiency; mitral valve stenosis; mitral valve replacement;

How to cite this article
Gökhan Lafçı, Adem İlkay Diken, Hikmet Selçuk Gedik, Kemal Korkmaz, Fırat Özcan, İrfan Taşoğlu, Garip Altıntaş, Kerim Çağlı. Alterations in pulmonary artery pressure following mitral valve replacement. Turk Kardiyol Dern Ars. 2012; 40(3): 235-241

Corresponding Author: Adem İlkay Diken, Türkiye
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