Should Near Systemic Pulmonary Hypertension be a Contraindication for Rheumatic Mitral Stenosis Valve surgery in Egyptian population?

Ahmed Mostafa Omran, National Heart Institute,EgyptFollow
Hany Fayed, National heart Institute,EgyptFollow

Article Type

Original Study

Subject Area

Cardiothoracic Surgery

Abstract

Background: pulmonary hypertension is a well known risk factor leading to mortality and morbidity in Mitral stenosis patients, in spite of long term outcome are being comparable regarding severe and mild or moderate pulmonary hypertension but definitely short term results are worse.

Objective: new management protocol to decrease the immediate postoperative differences between patients having Mitral stenosis with near systemic pulmonary hypertension compared to patients with mild or moderate pulmonary hypertension.

Patients and Methods: Prospective cohort single centre study was held in National heart institute, between 2016 and 2022, on patients undergoing Mitral valve surgery for Mitral stenosis with near systemic hypertension.Inclusion criteria, 18 to 60 years with isolated Mitral stenosis ( +/- tricuspid valve) and pulmonary hypertension > 80 mmHg who will undergo Mitral valve surgery. Previous bosentan or other endothelin receptor antagonist or pulmonary disease that may affect pulmonary artery pressure or history of pulmonary embolism are excluded from the study.Also patients with other valve disease, redo cases or IHD .Comparison will be done with patients with mild to moderate PH, by assigning patients to 2 groups (PAP> 80 and control PAP< 50), study group will follow the study protocol. Both groups will receive also the standard treatment.

Results: No significant difference in preoperative variables apart from NYHA class, Pulmonary artery pressure (p< 0.001), operatively cross clamp time was lower in the study group ( 32 ±8.1vs 45 ±6.8). Post operatively short term mortality and morbidity were comparable with the control group.

Conclusion: Strict protocol can be a solution for high short term mortality and morbidity in patients having Mitral stenosis and near systemic pulmonary hypertension.

IRB Number

IHC00045

Keywords

Pulmonary hypertension, Mitral valve, near systemic, Mitral stenosis.

Recommended Citation

Omran, Ahmed Mostafa and Fayed, Hany (2023) "Should Near Systemic Pulmonary Hypertension be a Contraindication for Rheumatic Mitral Stenosis Valve surgery in Egyptian population?," Journal of Medicine in Scientific Research: Vol. 6: Iss. 1, Article 1.
DOI: https://doi.org/10.59299/2537-0928.1001