Objectives: To assess the early outcome after elective isolated or concomitant mitral valve replacement (MVR) in patients with pulmonary hypertension (PH). Subjects and methods: The study included patients with baseline systolic pulmonary artery pressure (PAPs) of at least 35 mmHg measured by echo who underwent elective MVR and/or aortic valve replacement (AVR). | Journal of military pharmaco-medicine no2-2018 EVALUATION THE CRITICAL CARE PERIOD RESULTS AFTER ISOLATED MITRAL VALVE REPLACEMENT OR SIMULTANEOUS MITRAL AND AORTIC VALVE SURGERY IN PATIENTS WITH PULMONARY HYPERTENSION Kieu Van Khuong*; Pham Thi Hong Thi**; Nguyen Quoc Kinh*** SUMMARY Objectives: To assess the early outcome after elective isolated or concomitant mitral valve replacement (MVR) in patients with pulmonary hypertension (PH). Subjects and methods: The study included patients with baseline systolic pulmonary artery pressure (PAPs) of at least 35 mmHg measured by echo who underwent elective MVR and/or aortic valve replacement (AVR). The systemic and pulmonary hemodynamic changes, arterial and mixed venous blood gas parameters were reported at various time points before and after operation. Preoperative and postoperative transthoracic echocardiography was performed. Results: Sixty seven patients (15 males and 52 females), arithmetic mean age was ± years (min - max: 20 - 68) were included in the study. The operative mortality rate was . The receiver operating characteristic curves identified PAPs as a good predictor of operative mortality. Postoperatively, there was a significant reduction in left atrial diameter (LAd). The arithmetic mean PAPs and pulmonary artery occlusion pressure (PAOP) decreased significantly after cardiopulmonary bypass (CPB) and persisted throughout the study period. Central venous pressure (CVP) decreased after CPB time and remained so to PAC removing time point, postoperatively. A decrease in SvO2 was significant after operation. Conclusion: Proper perioperative care and anesthetic techniques resulted in the improvement of LAd, PAPs, PAOP, with acceptable operative mortality in patients with PH who was performed elective isolated MVR or simultaneous mitral and AVR. * Keywords: Pulmonary hypertension; Aortic valve replacement; Mitral valve replacement. INTRODUCTION All around the world, rheumatic heart disease .
