Early outcomes of mitral valve replacement with a mechanical prosthesis for rheumatic mitral valve disease.

  • Musfireh Siddiqeh Rawalpindi Institute of Cardiology, Rawalpindi.
  • Imran Khan Al Mana General Hospital, Al Khobar, Saudi Arabia.
  • Zainab Farid Rawalpindi Institute of Cardiology, Rawalpindi
  • Fakhar e Fayyaz ACC, Lahore
  • Qudsia Anjum Rawalpindi Institute of Cardiology, Rawalpindi
Keywords: In- Hospital Outcomes, Mechanical Prosthesis, Mitral Valve Replacement, Rheumatic Valve Pathology

Abstract

Objectives: To study the early outcomes of mitral valve replacement with a mechanical prosthesis is patients with rheumatic mitral valvular disease.  Study Design: Retrospective Observational study. Setting: Punjab Institute of Cardiology, Lahore and Rawalpindi Institute of Cardiology, Rawalpindi. Period: From August 2014 to August 2017. Material & Methods: Consecutive patients who underwent mitral valve replacement for a rheumatic pathology were included in the study. Patients undergoing a redo surgery, those with concomitant aortic valve intervention, coronary artery bypass grafting and emergency procedures were excluded from the study. Results: Of the 104 patients included in the study, 58 (56.2%) were female patients. The mean age of the patients was 35 ± 12.36 years (median 33 years). Sixty (58.5%) had hypertension and 22 (21.28%) had diabetes. Mitral valve stenosis was the main pathology in 84 (81.25%). Severe pulmonary hypertension was recorded in 15 (15%) patients. The mean preoperative Tricuspid Valve Pressure Gradient (TVPG) was 55.33 ± 18.35 mmHg. The mean cross clamp time was 45.33 ± 12.32 minutes. The postoperative tricuspid valve pressure gradient came down to 31.5 ± 12.21 mmHg. No patients had acute renal injury, pulmonary complications or re-exploration for bleeding. Perioperative mortality was 4 (3.75%). Conclusion: Rheumatic valvular disease is still prevalent in our part of the world. Most of the patients with rheumatic heart disease will end up with replacement of the valve. Replacement with a mechanical prosthesis has favorable early outcomes.

Author Biographies

Musfireh Siddiqeh, Rawalpindi Institute of Cardiology, Rawalpindi.

MBBS, MCPS, FCPS (Gen Surg), FCPS (Card Surg)

Assistant Professor Cardiac Surgery

Imran Khan, Al Mana General Hospital, Al Khobar, Saudi Arabia.

MBBS, FCPS

Consultant Surgeon

Zainab Farid, Rawalpindi Institute of Cardiology, Rawalpindi

MBBS, FCPS

Senior Registrar Cardiac Anesthesia

Fakhar e Fayyaz, ACC, Lahore

FCPS (Anesthesia), FCPS (Cardiac Anesthesia)

Associate Professor Anesthesia

 

Qudsia Anjum, Rawalpindi Institute of Cardiology, Rawalpindi

MBBS, FCPS (Anesthesia)

Assistant Professor Anesthesia

Published
2020-10-10