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Early change of oxygen metabolism after isolated mitral valve replacement or mitral valve replacement and concomitant aortic valve replacement in patients with pulmonary hypertension

Objectives: To verify oxygen metabolic changes and to assess the corellation between oxygen consumption (VO2), oxygen delivery (DO2) and oxygen extraction (ERO2). Subjects and methods: 67 patients with pulmonary hypertension related left heart diseases who underwent elective (MVR) and/or aortic valve replacement (AVR) enrolled in the study. Calculated parameters by pulmonary artery catheter inserted at operation theater and monitor system. | Journal of military pharmaco-medicine n03-2018 EARLY CHANGE OF OXYGEN METABOLISM AFTER ISOLATED MITRAL VALVE REPLACEMENT OR MITRAL VALVE REPLACEMENT AND CONCOMITANT AORTIC VALVE REPLACEMENT IN PATIENTS WITH PULMONARY HYPERTENSION Kieu Van Khuong*; Pham Thi Hong Thi**; Nguyen Quoc Kinh*** SUMMARY Objectives: To verify oxygen metabolic changes and to assess the corellation between oxygen consumption (VO2), oxygen delivery (DO2) and oxygen extraction (ERO2). Subjects and methods: 67 patients with pulmonary hypertension related left heart diseases who underwent elective (MVR) and/or aortic valve replacement (AVR) enrolled in the study. Calculated parameters by pulmonary artery catheter inserted at operation theater and monitor system. Results and conclusion: Cardiac output index (CI), ERO2 and VO2 increased significantly intra and after operation with respect to baseline levels. DO2 decreased after intubation and cardiopulmonary bypass stop but increased significantly at intensive care unit admission. The close corellation between VO2 and DO2, ERO2 was at all postoperative points of time. * Keywords: Mitral valve replacement; Pulmonary hypertension; Oxygen delivery; Oxygen metabolism; Aortic valve replacement. INTRODUCTION The important problems of postoperative cardiac care are those of cardiac output, tissue oxygenation, the ratio of myocardial oxygen supply and demand. Ideally, one should strive to obtain a cardiac index greater than 2.2 L/min/m2 with a normal mixed venous oxygen saturation while optimizing the oxygen supply/demand ratio. Oxygen delivery (DO2) is considered as principal target for adequate tissue perfusion [1]. anerobic metabolism occurs. From this point, the resulting oxygen debt leads to increased arterial lactate production. This physiological dependence of oxygen consumption (VO2) on DO2 should be avoided, as hyperlactatemia is associated with increased postoperative mortality, morbidity and hospital length of stay. Previous studies have .