Left ventricular function and morphology after cardiac surgery for severe mitral insufficiency-a single center experience

Abstract

Introduction

Mitral insufficiency is a common valvular disease affecting 10% of the general population. The main treatment of the severe mitral regurgitation is surgical. We have analyzed the impact of cardiac surgery on the left ventricular performance and morphology, in patients treated for severe mitral insufficiency accordingly to the type of intervention, ischemic time and type of cardioplegia.

Methods

One hundred and twenty-nine patients diagnosed with severe mitral insufficiency that benefited from mitral valvular replacement or mitral valvuloplasty were retrospectively enrolled. Left ventricle, left atrium diameters and left ventricle ejection fraction were measured by two-dimensional (2D) echocardiography before and after surgery. The influence of the myocardial ischemia time and the type of cardioplegia administered on the ventricular systolic function were also analyzed.

Results

No matter the surgical technique chosen, after surgery we noticed a decrease in size of the left atrium (52,83mm vs 50,68mm, p=0,0001)and left ventricle (55,89mm vs 52,59mm, p=0,0001), as well as of the ejection fraction (50,33% 46,28%, p=0,0001).

In relation to the myocardial ischemia duration (r=0,06; p=0,58) and the type of cardioplegia administered: Calafiore (mean EF=49,94%+- 8,07%) or Custodiol (mean EF=45,16%+- 8,01%), p=0,3, nonsignificant influence on the ejection fraction was noticed.

Conclusions

A decrease in the size of the left cavities is noticed post-surgery, with the decrease of the ejection fraction immediately post-surgery. In our trial, the myocardial ischemia duration, respectively the type of cardioplegia administered do not influence the amendment of the ejection f