- Turkish Journal of Thoracic and Cardiovascular Surgery

The Pulmonary Hypertension Before and After Mitral Valve Replacement

İsmet Pezo MD, Atilla Kanca MD, Murat Konuk MD, Mehmet Uğur Es MD, Mehmet Abuç MD

Prof. Dr. Siyami Ersek İstanbul Thoracic and Cardiovascular Surgery Center, İstanbul

The authors have presented thirty-five patients with mitral valve replacement and pulmonaryhpertension. The mean age of this grup was 46.37 years. İn all of patients a preoperative and postoperative catheterization and body plethysmography underwent. The following farameters vere examined: truncus arteriae pulmonalis mean pressure (TAPm), wedge, mean pressre (Wm), total pulmonary vascular resistance (TPVR), cardiac index (CI), vital capacity (VC), saturation of hemaglobin in arterial blodd (Sat O2), transfer factor DLCO, and Krogh constant (DLCO/VA). Transfer faktor and Krogh constant shows the volume of pulmonary capilary blood or the number of pulmonary capillary vessels on the surface unit.

The pulmonary vascular pressures have significantly decreased after mitral valve replacement (TAPm from 45.48 mm Hg to 28.42 mm Hg; Wm from 27.5 mmHg to 16.39 mmHg ), TPVR have insignificantly decreased and transfer factor is significantly diminished only in the group of patients with TAP m 41+/-14 mmHg, Wm 26+/-5 mmHg and TPVR, 10.3 +/-4.26 Units.

İn conclusion, there is no contraindication for operation of mitral valve disease in regard to the pulmonary hypertension. The pulmonary hypertension is the result of the increased pulmonary vascular resistance caused by inital pathological changes on the pulmonary vascular bed. The restrictive changes of the pulmonary ventilation are moderate and irreversible, but there is not significant influence on the alvealo-capillary diffusion.

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