A Multi Center Experience: Is Valve Replacement Safe for Patients with Hugely Dilated Left Ventricle?

  • Ahmed Ahmed Cardiothoracic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt http://orcid.org/0000-0003-4748-6282
  • Ahmed Toema Cardiothoracic Surgery Department, Faculty of Medicine, Helwan University, Cairo, Egypt
  • Ahmed Yehia Cardiothoracic Surgery Department, Faculty of Medicine, Helwan University, Cairo, Egypt
  • Yassin Hashim Cardiothoracic Surgery Department, Faculty of Medicine, Helwan University, Cairo, Egypt
  • Mohamed Elkahely Cardiothoracic Surgery Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt
  • Ahmed Onsy Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Keywords: Dilated left ventricle, Mitral regurgitation, Aortic regurgitation

Abstract

Background: Dilated left ventricle occurs in chronic aortic and mitral regurgitations. We describe the early outcome of mitral and aortic valve replacement for patients with severely dilated left ventricle in different
surgical interventions.

Methods: From March 2014 to December 2018, 620 patients with left ventricular end-diastolic diameter (LVEDD) of ≥ 70 mm underwent valve replacement procedures in 8 cardiac surgery centers in Egypt. One hundred ninety four cases (31.3%) underwent aortic valve replacement, 173 cases (27.9%) underwent mitral valve replacement, 123 cases (19.9%) underwent double valve replacement, 59 cases (9.5%) underwent double valve replacement with either tricuspid valve repair or replacement, 33 cases (5.3%) underwent mitral valve replacement with either tricuspid valve repair or replacement, 20 cases (3.2%) underwent mitral valve replacement with CABG, 10 cases (1.6%) underwent aortic valve replacement with CABG, while 8 cases (1.3%) underwent aortic valve replacement with ascending aortic
aneurysm repair.

Results: Four patients (0.6%) developed new postoperative renal failure, which required dialysis. Twenty-nine patients (4.7%) required reoperation for bleeding. One patient (0.2 %) developed sternal dehiscence. Five patients (0.8%) postoperatively developed stroke. Twenty-five patients (4%) died, and the main causes of death were low cardiac output and sepsis with eventual multi-organ failure.

Conclusion: Valve replacement in patients with hugely dilated left ventricle are safe operations with satisfactory outcomes even if combined with other procedures, especially with proper preoperative preparation, intraoperative preservation of posterior mitral leaflet, and meticulous postoperative follow up in the surgical ICU.

References

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Published
2019-11-25
How to Cite
Ahmed, A., Toema, A., Yehia, A., Hashim, Y., Elkahely, M., & Onsy, A. (2019). A Multi Center Experience: Is Valve Replacement Safe for Patients with Hugely Dilated Left Ventricle?. The Heart Surgery Forum, 22(6), E452-E455. https://doi.org/10.1532/hsf.2541
Section
Articles