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Dynamics of pulmonary hypertension after mitral valve prosthetic replacement long term results


, : Dynamics of pulmonary hypertension after mitral valve prosthetic replacement long term results. Kardiologiya 16(10): 80-87

Hemodynamic parameters were obtained during right and left heart catheterization in 51 patients following mitral valve prosthetic replacement for rheumatic mitral disease. In 30 patients the examination was conducted preoperatively and postoperatively, and in 21 postoperatively only. A comparative analysis of the preoperative and postoperative hemodynamic indices showed that when the effect of surgery is positive, the pressure in the pulmonary artery, the wedge pressure, the right atrial and the end-diastolic pressures in the right and left ventricle decrease. A reduction is also noted in the pulmonary-arteriolar resistance, in the arterio-venous O2 content gradient and in the right ventricle work, and an increase in the cardiac output, cardiac index and effective work of the left ventricle. The dynamics of these parameters is especially dramatic in patients with severe pulmonary hypertension (the pulmonary artery pressure falls by 60% and the pulmonary-arteriolar resistance by 83%). When surgery fails to produce any hemodynamic effect, the intracardiac hemodynamic disorders persist along with those in the pulmonary circulation.

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