Publication Sub Type
Journal Article, Original
Philippine Journal of Cardiology
Post-operative left ventricular dusfunction (LVD) is the most common cause of mortality in patients after mitral valve (MV) surgery due to mitral regurgitation (MR). The aims of this study were to determine two-dimensional echocardiography (2-D Echo) parameters that might predict the left ventricular response after MV surgery and eventually to note the timing of surgery for optimum results.
Of the 44 patients who underwent MV surgery for pure MR of rheumatic etiology at the Philippine Heart Center between to 1983 to 1994, only 40 charts were available for review. The mean age were between 15± 3 y/o with 21 females and 19 males. Echocardiogram done 1 week pre-operatively and 1 to 3 months postoperatively were reviewed for the following parameters: left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left atrial (LA) size and ejection fraction )EF).Measurements of LVEDD, LVESD and LA were based on Zile's recommendation using body surface area. Of the 40 patients reviewed, 15 died within the first 3 months after surgery. There were 7 patients with LVEDD less than 4 cm/m² and 6 improved while 1 expired due to infective endocarditis. Of the 33 whose LVEDD was more than 2 cm/m², 19 did not improve which included 14 mortalities and this was significant (p<0.05). There were 5 patients who had LVESD less than 2.6 cm/m². Sixteen did not improve with 13 mortalities which was not significant (p>0.05). Ejection fraction less than 50% were noted in 10 patients, all of whom expired while in 30 with EF more than 50%, 15 did not improve with 5 mortalities which was significant (p<0.01). Thirty eight patients had an LA size of >24 cm and 18 did not improve including 15 mortalities. We conclude that LVEDD less than 4 cm/m² and EF more than 50% were good predictors of improvement after MV surgery for patients with pure MR rheumatic in origin.
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