Current Issue

Immediat and Long Term Results of Mitral Valve Replacement in Patients with Rheumatic Mitral Stenosis and Left Ventricular Dysfunction

Siham Bellouize1, Nadia loudiyi2, Mohammed.Drissi3, Mahdi Ait Houssa4

 DOI : https://dx.doi.org/10.18535/rajar/v4i3.04

 Author's Affiliations

1,4Cardiac surgery department Mohammed V Military Hospital

2Cardiac department Mohammed V Military Hospital

3Reanimation of cardiac surgery department Mohammed V Military Hospital


 

SUMMARY

-Objective: The aim of this study was to assess the reversibility of left ventricular dysfunction in patients with rheumatic valve stenosis mitral stenosis after mitral valve surgery.
Patients and methods: We retrospectively collected 565 patients who underwent mitral valve replacement for mitral stenosis. patients who had moderate tricuspid regurgitation (I-II) were included. Patients were studied under two groups: group with LVFE > 45% (n=535) and group with LVEF≤ 45% (n=30).
All patients underwent mitral valve surgery under cardiopulmonary bypass (CPB). Follow up evaluated the NYHA functional class and LVEF and survival rate.
-Results: The groups were similar for most preoperative characteristics. No statistical difference was observed between groups in term of CPB time and aortic cross clamp time. But 30 days mortality rate was higher in patients with LV dysfunction (13.3%, vs 4.5%, p=0.03). Low output syndrome was more frequent also (p=0.028) in group with MS and poor LVEF. Mean follow up time was 69.6± 29.2 months. Preoperative NYHA class was 2.83± 0.04 vs 1.27±0.04 after surgery p=0.001. LVEF increased from 39.8±45% to 52.8±86%  p= 0.017.
No change was seen in LV diameters.
-Conclusion: Despite higher perioperative mortality in patients with MS and poor LV dysfunction, MVR provides excellent outcome and LVEF recovery.