ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
THE RESULTS OF MITRAL VALVE SURGERY IN PATIENTS WITH SEVERE PULMONARY HYPERTENSION
Ali Civelek, Atike Tekeli, Serdar Akgün, *Tekin Yıldırım, Selim İsbir, **Mine Öz, **Nazan Aksoy, *Sinan Arsan
Marmara Üniversitesi Tıp Fakültesi, Kalp Damar Cerrahisi Ana Bilim Dalı, İstanbul
*Maltepe Üniversitesi Tıp Fakültesi, Kalp Damar Cerrahisi Ana Bilim Dalı, İstanbul
**Maltepe Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Ana Bilim Dalı, İstanbul
Background: Severe pulmonary hypertension is still one of the main causes of morbidity and mortality in mitral valve surgery. Here, we presented the early results of mitral valve surgery in patients with severe pulmonary hypertension.

Methods: Sixty-three patients with severe pulmonary hypertension underwent mitral valve surgery between January 2001 and November 2002. Thirty-eight (%60.3) patients were female, 25 (%39.7) patients were male, the mean age of the patients was 49.5 ± 10.5 (ranged 24 to 68 years). Preoperatively 38 (%60.3) patients were in New York Heart Association (NYHA) functional class IV, 15 (%23.8) patients in NYHA class III and 10 (%15.8) patients were in NYHA class II. Preoperative echocardiographic assessments were performed in all patients. Thirty (%47.6) patients underwent isolated mitral valve replacement (MVR), 15 (%24) patients underwent both MVR and aortic valve replacement, and 18 (%28.5) patients underwent MVR and tricuspid valve de Vega annuloplasty.

Results: The early mortality rate was 7.93% (n = 5), and late mortality rate was 1.7% (n = 1). The functional capacity of the patients improved significantly: 20 (%35) patients were in NYHA class I, 31 (%55) patients in NHYA class II, and 6 (%10) patients in NYHA class III postoperatively (p < 0.05). Systolic pulmonary artery pressure dropped from 83.06 ± 12.9 mmHg to 39.6 ± 14 mmHg (p < 0.001).

Conclusions: Patients with mitral valve disease benefit from surgical treatment regardless of the degree of pulmonary hypertension. Pulmonary hypertension decreases significantly after operation.

Keywords : Mitral valve replacement, pulmonary hypertension
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