Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral Stenosis
Background: In patients with mitral stenosis (MS), right ventricular (RV) function may be altered due to an increase in the left atrial pressure and/or changes in pulmonary arteriolar vasculature or may be affected by rheumatic process directly. Aims: In this study we have evaluated the recovery of...
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Wolters Kluwer Medknow Publications
2020-01-01
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Series: | Journal of the Indian Academy of Echocardiography & Cardiovascular Imaging |
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Online Access: | http://www.jiaecho.org/article.asp?issn=2543-1463;year=2020;volume=4;issue=3;spage=232;epage=236;aulast=Swaminathan |
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doaj-5cfddc277e374953b3fedebdac8387302021-08-20T06:10:00ZengWolters Kluwer Medknow PublicationsJournal of the Indian Academy of Echocardiography & Cardiovascular Imaging2543-14632543-14712020-01-014323223610.4103/jiae.jiae_9_20Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral StenosisN SwaminathanVenkatesan S SangareddiG RavishankarJustin PaulL Alen BinnyBackground: In patients with mitral stenosis (MS), right ventricular (RV) function may be altered due to an increase in the left atrial pressure and/or changes in pulmonary arteriolar vasculature or may be affected by rheumatic process directly. Aims: In this study we have evaluated the recovery of RV function upto 3 months in patients undergoing mitral valve replacement (MVR) using two dimensional and tissue Doppler echocardiographic indices (TDI). Materials and Methods: A total of 30 patients who were advised MVR were enrolled prospectively. All patients underwent MVR successfully. RV function was assessed using conventional and TDI pre-operatively, 1 week, and 3 months after surgery. Results: New York Heart Association (NYHA) functional class improved significantly at the end of one week. Mean transmitral gradient reduced postoperatively. Tricuspid regurgitation severity reduced significantly. Significant RV reverse remodelling was noted at the end of 3 months. Global RV function parameters fractional area change and RV Tei index improved significantly at the end of 3 months. In patients with mild to moderate pulmonary hypertension (PH), global RV function improved significantly, RV remodelling was seen. In patients with severe PH, both global and longitudinal functions did not improve at the end of 3 months follow up, though RV remodelling was noticed. Conclusion: In patients with severe rheumatic MS whenever per-cutaneous trans-mitral commissurotomy is not feasible, MVR promotes RV remodelling and improvement in RV function along with significant improvement in NYHA functional status. But this improvement in RV function was noted only in patients with mild to moderate PH rather than in patients with severe PH.http://www.jiaecho.org/article.asp?issn=2543-1463;year=2020;volume=4;issue=3;spage=232;epage=236;aulast=Swaminathanmitral stenosismitral valve replacementpulmonary hypertensionright ventricle function |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
N Swaminathan Venkatesan S Sangareddi G Ravishankar Justin Paul L Alen Binny |
spellingShingle |
N Swaminathan Venkatesan S Sangareddi G Ravishankar Justin Paul L Alen Binny Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral Stenosis Journal of the Indian Academy of Echocardiography & Cardiovascular Imaging mitral stenosis mitral valve replacement pulmonary hypertension right ventricle function |
author_facet |
N Swaminathan Venkatesan S Sangareddi G Ravishankar Justin Paul L Alen Binny |
author_sort |
N Swaminathan |
title |
Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral Stenosis |
title_short |
Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral Stenosis |
title_full |
Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral Stenosis |
title_fullStr |
Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral Stenosis |
title_full_unstemmed |
Impact of Mitral Valve Replacement on the Right Ventricle Function in Mitral Stenosis |
title_sort |
impact of mitral valve replacement on the right ventricle function in mitral stenosis |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of the Indian Academy of Echocardiography & Cardiovascular Imaging |
issn |
2543-1463 2543-1471 |
publishDate |
2020-01-01 |
description |
Background: In patients with mitral stenosis (MS), right ventricular (RV) function may be altered due to an increase in the left atrial pressure and/or changes in pulmonary arteriolar vasculature or may be affected by rheumatic process directly. Aims: In this study we have evaluated the recovery of RV function upto 3 months in patients undergoing mitral valve replacement (MVR) using two dimensional and tissue Doppler echocardiographic indices (TDI). Materials and Methods: A total of 30 patients who were advised MVR were enrolled prospectively. All patients underwent MVR successfully. RV function was assessed using conventional and TDI pre-operatively, 1 week, and 3 months after surgery. Results: New York Heart Association (NYHA) functional class improved significantly at the end of one week. Mean transmitral gradient reduced postoperatively. Tricuspid regurgitation severity reduced significantly. Significant RV reverse remodelling was noted at the end of 3 months. Global RV function parameters fractional area change and RV Tei index improved significantly at the end of 3 months. In patients with mild to moderate pulmonary hypertension (PH), global RV function improved significantly, RV remodelling was seen. In patients with severe PH, both global and longitudinal functions did not improve at the end of 3 months follow up, though RV remodelling was noticed. Conclusion: In patients with severe rheumatic MS whenever per-cutaneous trans-mitral commissurotomy is not feasible, MVR promotes RV remodelling and improvement in RV function along with significant improvement in NYHA functional status. But this improvement in RV function was noted only in patients with mild to moderate PH rather than in patients with severe PH. |
topic |
mitral stenosis mitral valve replacement pulmonary hypertension right ventricle function |
url |
http://www.jiaecho.org/article.asp?issn=2543-1463;year=2020;volume=4;issue=3;spage=232;epage=236;aulast=Swaminathan |
work_keys_str_mv |
AT nswaminathan impactofmitralvalvereplacementontherightventriclefunctioninmitralstenosis AT venkatesanssangareddi impactofmitralvalvereplacementontherightventriclefunctioninmitralstenosis AT gravishankar impactofmitralvalvereplacementontherightventriclefunctioninmitralstenosis AT justinpaul impactofmitralvalvereplacementontherightventriclefunctioninmitralstenosis AT lalenbinny impactofmitralvalvereplacementontherightventriclefunctioninmitralstenosis |
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1721201400767053824 |