Small Cavity of Left Ventricle Does Not Affect Short-term Outcome in Patients with Rheumatic Mitral Valve Stenosis Undergoing Mitral Valve Replacement

Authors

  • Junnan Zheng, MD Department of Cardiovascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • Tingting Tao, MD Department of Cardiovascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • Yiming Ni, MD Department of Cardiovascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • Liang Ma, MD Department of Cardiovascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • Haige Zhao, MD Department of Cardiovascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

DOI:

https://doi.org/10.1532/hsf.3335

Keywords:

Small cavity of left ventricle, mitral valve replacement, rheumatic mitral valve stenosis, prosthesis-patient mismatch

Abstract

Background: Small cavity left ventricle (SCLV) may affect the clinical outcomes of patients undergoing mitral valve replacement (MVR). This study aims to investigate the incidence of SCLV in patients with rheumatic mitral valve stenosis undergoing MVR and analyze its effect on short-term patient outcomes.

Methods: We retrospectively examined all consecutive patients with isolated or concomitant MVR for rheumatic mitral valve stenosis in our center from 2013 to 2018. SCLV was defined as end-diastolic volume index ≤ 50 ml/m2. After inclusion and exclusion, a total of 1,437 patients were analyzed. The baseline information was collected and compared between SCLV and non-SCLV patients. Multivariate logistic regression analysis was conducted to determine the effect of SCLV on early mortality.

Results: A total of 1,437 patients were included in the study. SCLV was detected in 13.57% of the patients. Compared with the non-SCLV group, patients with SCLV were smaller-sized and primarily female. There were no significant differences between SCLV and non-SCLV patients regarding major postoperative complications, nor were there incidence of prosthesis-patient mismatch. Logistic regression analysis showed that SCLV was not a risk factor for short-term mortality (P = 0.998).

Conclusions: Our results demonstrated that SCLV was not associated with poorer early outcomes after MVR surgery in patients with rheumatic mitral valve stenosis.

References

Abbo KM, Carroll JD. 1994. Hemodynamics of mitral stenosis: A review. Cathet Cardiovasc Diagn Suppl. 2:16-25.

Akuffu AM, Zhao H, Zheng J, Ni Y. 2018. Prosthesis-patient mismatch after mitral valve replacement: A single-centered retrospective analysis in east china. J Cardiothorac Surg. 13:100.

Bitar JN, Lechin ME, Salazar G, Zoghbi WA. 1995. Doppler echocardiographic assessment with the continuity equation of St. Jude medical mechanical prostheses in the mitral valve position. Am J Cardiol. 76:287-93.

Borracci RA, Rubio M, Sestito ML, Ingino CA, Barrero C, Rapallo CA. 2016. Incidence of prosthesis-patient mismatch in patients receiving mitral biocor(r) porcine prosthetic valves. Cardiol J. 23:178-83.

Chandrashekhar Y, Westaby S, Narula J. 2009. Mitral stenosis. Lancet 374:1271-83.

Cohn LH. 2012. Cardiac surgery in the adult. 4th ed. New York: McGraw-Hill Medical.

Gash AK, Carabello BA, Cepin D, Spann JF. 1983. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation. 67:148-54.

Gomez-Duran C. 1984. Recent progress in mitral valve disease. London: Butterworths.

Harb SC, Griffin BP. 2017. Mitral valve disease: A comprehensive review. Curr Cardiol Rep. 19:73.

Horstkotte D, Niehues R, Strauer BE. 1991. Pathomorphological aspects, aetiology and natural history of acquired mitral valve stenosis. Eur Heart J. 12 Suppl B:55-60.

Hosono M, Shibata T, Sasaki Y, et al. 2008. Left ventricular rupture after mitral valve replacement: Risk factor analysis and outcome of resuscitation. J Heart Valve Dis. 17:42-7.

Jett GK, Jett MD, Bosco P, van Rijk-Swikker GL, Clark RE. 1986. Left ventricular outflow tract obstruction following mitral valve replacement: Effect of strut height and orientation. Ann Thorac Surg. 42:299-303.

Jiang SL, Gao CQ, Li BJ, et al. 2009. [structural and functional changes of postoperative small left ventricle patients]. Zhonghua Wai Ke Za Zhi. 47:924-6.

Kou S, Caballero L, Dulgheru R, et al. 2014. Echocardiographic reference ranges for normal cardiac chamber size: Results from the norre study. Eur Heart J Cardiovasc Imaging. 15:680-90.

Lam BK, Chan V, Hendry P, et al. 2007. The impact of patient-prosthesis mismatch on late outcomes after mitral valve replacement. J Thorac Cardiovasc Surg. 133:1464-73.

Liu CP, Ting CT, Yang TM, et al. 1992. Reduced left ventricular compliance in human mitral stenosis. Role of reversible internal constraint. Circulation. 85:1447-56.

Magne J, Mathieu P, Dumesnil JG, et al. 2007. Impact of prosthesis-patient mismatch on survival after mitral valve replacement. Circulation. 115:1417-25.

Mohan JC, Chutani SK, Sethi KK, Arora R, Khalilullah M. 1990. Determinants of left ventricular function in isolated rheumatic mitral stenosis. Indian Heart J. 42:175-9.

Popov V, Shimon V, Yu L. 2013. Mitral valve replacement with small cavity of left ventricle. Journal of Cardiothoracic Surgery. 8:1-.

Wenbin L, Jianqun Z, Qiwen Z, et al. 2002. Surgical treatment of mitral regurgitation associated with enlarged left ventricle. J Heart Valve Dis. 11:181-4.

Zile MR, Tomita M, Ishihara K, et al. 1993. Changes in diastolic function during development and correction of chronic lv volume overload produced by mitral regurgitation. Circulation. 87:1378-88.

Published

2021-01-15

How to Cite

Zheng, J., Tao, . T., Ni, Y., Ma, L., & Zhao, H. (2021). Small Cavity of Left Ventricle Does Not Affect Short-term Outcome in Patients with Rheumatic Mitral Valve Stenosis Undergoing Mitral Valve Replacement. The Heart Surgery Forum, 24(1), E031-E037. https://doi.org/10.1532/hsf.3335

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Articles