Key result
Mitral valve replacement is linked to improved six-month pulmonary function in severe pulmonary hypertension.
Why the study?
Does mitral valve replacement surgery improve pulmonary functions in patients with rheumatic mitral affection and preoperative pulmonary hypertension?
Observational (n=42)
Does mitral valve replacement surgery improve pulmonary functions in patients with rheumatic mitral affection and preoperative pulmonary hypertension?
Mitral valve replacement in patients with rheumatic mitral disease and severe pulmonary hypertension leads to significant improvement in pulmonary function over 6 months, despite initial early postoperative impairment.
May support MVR consideration in severe PH; hypothesis-generating and requires RCTs before practice change.
Background: Mitral valve replacement surgery has a great impact on pulmonary functions specially in patients with preoperative pulmonary hypertenstion. Spirometry test can be used to measure the changes in pulmonary function after mitral valve replacement surgery of cases with pulmonary hypertension.Aim: To clarify pulmonary function changes after mitral valve replacement of cases.Methods and Material: This study was carried out on forty-two patients subjected to mitral valve replacement surgery due to rheumatic mitral affection. Those patients divided into two groups, Group 1 included twelve patients subjected to mitral valve replacement having no preoperative pulmonary hypertension and Group 2 included thirty patients subjected to mitral valve replacement having pre-operative various degree of pulmonary hypertension. Group 2 are furtherly subdivided into three subgroups according to Systolic Pulmonary Artery Pressure (SPAP) during rest. Pulmonary functions evaluated two days pre-operatively, at discharge of patients, three and six months post-operatively.Results: Pulmonary function tests impaired pre-operatively in association with severity of pulmonary hypertension and more impairment early after mirtal valve repacement was noticed and recovers gradually along six months later post-operatively with statistically significant among the severe pulmonary hypertension group.Conclusions: There is no correlation between the reduction of pulmonary hypertension and the improvement of pulmonary functions, so we can’t depend on pulmonary function as a predictor of reduction in pulmonary hypertension after mitral valve replacement surgery due to small sample size. Patients with severe pulmonary hypertension pre-operatively, showed statistically significant improvement in the pulmonary functions during the six months post-operatively.
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Attia et al. (2018) conducted an observational in Rheumatic mitral affection requiring mitral valve replacement (n=42). Pre-operative pulmonary hypertension vs. No pre-operative pulmonary hypertension was evaluated on Pulmonary function changes. Mitral valve replacement in patients with severe pre-operative pulmonary hypertension resulted in a statistically significant improvement in pulmonary functions over six months post-operatively.
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