Korean J Anesthesiol.  2003 Feb;44(2):193-200. 10.4097/kjae.2003.44.2.193.

Effect of Mitral Disease on the Change of Right Ventricular Function Following Mitral Valve Replacement

• Oh YJ
• Kwak YL
• Lee JH
• Shin HK
• Kwak HJ
• Hong YW

• KMID: 1935993
• DOI: http://doi.org/10.4097/kjae.2003.44.2.193

Abstract

BACKGROUND: Mitral stenosis (MS) and mitral regurgitation (MR) have different pathophysiologies and left ventricular function after miral valve replacement (MVR) in both diseases has been well known. However, there has been no report comparing the change of right ventricular (RV) function immediately after MVR. We evaluated the change of RV function following MVR in MS and MR using a RV ejection fraction (RVEF) thermodilution catheter.
METHODS
With IRB approval, 27 patients with MS and 22 patients with MR undergoing MVR were included. Patients with tricuspid regurgitation were excluded. A RVEF catheter was inserted before the induction of anesthesia. Hemodynamic parameters were measured after anesthesia (T1, control), immediately after the termination of cardiopulmonay bypass (T2) and after the sternum was closed (T3).
RESULTS
Pulmonary capillary wedge pressure (PCWP) and end systolic and end diastolic RV volume index (RVESVI and RVEDVI) were higher in MS than in MR and there was no difference in RVEF at T1. Heart rate increased and mean pulmonary artery pressure (mPAP), PCWP, and pulmonary vascular resistance significantly decreased at T2 in both groups. RVEF increased and RVESV and RVEDV decreased significantly only in MS after MVR versus that at T2. There was no difference in hemodynamic parameters between both groups at T2 and T3.
CONCLUSIONS
RV function was significantly improved in MS but not in MR after MVR. However, there was no significant hemodynamic difference between MS and MR after MVR, though they are known to have different preoperative pathophysilogies and postoperative left heart functions.

Keyword

Mitral valve replacement; right ventricular ejection faction thermodilution catheter; right ventricular function

MeSH Terms

Anesthesia
Catheters
Ethics Committees, Research
Heart
Heart Rate
Hemodynamics
Humans
Mitral Valve Insufficiency
Mitral Valve Stenosis
Mitral Valve*
Pulmonary Artery
Pulmonary Wedge Pressure
Sternum
Thermodilution
Tricuspid Valve Insufficiency
Vascular Resistance
Ventricular Function, Left
Ventricular Function, Right*