Medical Science
Volume 24, Issue 105, September - October, 2020
Right Ventricular Function after isolated Mitral valve Replacement in Rheumatic Mitral Stenosis with Pulmonary Hypertension
Ahmed M Nasr1♦, Ahmed M. Fathy Ghoneim1, Ahmed Abdel Galeel Ahmed2, Mohamed Alaa Nady1, Ahmed Elminshawy1
1Cardiothoracic Surgery Department, Faculty of Medicine, Assiut University, Egypt
2Cardiology Department, Faculty of Medicine, Assiut University, Egypt
♦Corresponding author
Cardiothoracic Surgery Department, Faculty of Medicine, Assiut University, Egypt
Email: nasr1987.cts@gmail.com
ABSTRACT
Background: Right ventricular global function (RVF) of the high pressure right ventricle in mitral stenosis patient's post Mitral Valve
Replacement (MVR) had not been well-defined. Objectives: We evaluated the MVR effects on RVF in immediate and mid-term postoperative periods for mitral stenosis status Methods: A prospective observational study was conducted on 80 patients with mitral stenosis. RVF evaluated pre, immediately post, 3 and 6 months Post MVR by both conventional and tissue Doppler
echocardiography imaging process. Where, evaluated patients were divided into 2 groups (Group (I) PAP>40 mm Hg, n: 26; Group
(II) PAP<40 mm Hg, n: 54) according to systolic pulmonary artery pressure which was recorded through using echocardiography
prior to MVR. Results: After MVR mean gradient, PASP and LA showed significant decrease. However, this PASP significance was
decreased at 3 to 6 months follow up (Mean SD from 42.67±11.3 to 47.36±13.69). Significant post MVR increase in TAPSE, RVFAC%,
E Peak in addition to significant decrease in RA maximal volume, deceleration time, A peak and MPI indicating improved RV
function.6 months follow up showed decreased significance of TAPSE, RA maximum volume and MPI. However, the significance was
lost in RVFAC%, A and E peak. Similar results were obtained on comparing group (II) with overall group. Conclusion: RVF improved
significantly after MVR during the immediate postoperative and short term, those positive effects decreased with patients
developing pulmonary hypertension (group II) for subsequent mid-term follow-ups. Denoting how important is to intervene in those
patients before development of pulmonary hypertension for a better RV response.
Keywords: Rheumatic mitral valve stenosis, PASP, pulmonary Hypertension, Myocardial Dysfunction
Medical Science, 2020, 24(105), 3336-3346
