Abstract
We studied 71 adult patients echocardiographically both before and 2-16 days (mean 8 days) after mitral valve surgery to systematically evaluate the early postoperative changes in cardiac dimensions and motion. The patients were divided into 4 groups: group I with predominant mitral stenosis (MS) (26 patients), group II with predominant mitral insufficiency (MI) (12 patients), group III with MS+MI (16 patients) and group IV with combined mitral and aortic valvular disease (17 patients). After operation the left atrial dimension at endsystole decreased (mean±standard deviation, 56±12 mm vs 46±11 mm, p<0.001), but did not completely normalize in the majority of patients. The left ventricular dimension at enddiastole decreased in group II from 67±12 mm to 54±5 mm (p<0.01) and in group IV from 59±13 mm to 54±13mm (p<0.01), but increased in group I from 43±8 mm to 46±9 mm (p<0.05). Mitral EF slope increased from 15±11 mm/sec to 52±20 mm/sec (p<0.001) after commissurotomy, and decreased from 136±61 mm/sec to 66±30 mm/sec (p<0.05) after annuloplasty. However, the postoperative means were subnormal in these subgroups. Paradoxical or hypokinetic septal motion occurred in 5/71 (7%) before and 50/71 (70%) after operation. We conclude that: 1) partial normalization of cardiac dimensions and subnormal mitral EF slopes shortly after mitral valve surgery suggest a residual pressure gradient across the mitral valve as well as partial irreversibility of the heart after longstanding mechanical overloading, and 2) postoperative abnormal septal motion, which may be caused by pericardiotomy, can occur after any type of open heart surgery.
Original language | English |
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Pages (from-to) | 509-521 |
Number of pages | 13 |
Journal | Japanese Heart Journal |
Volume | 25 |
Issue number | 4 |
DOIs | |
State | Published - 1984 |
Externally published | Yes |
Keywords
- Echocardiography
- Mitral insufficiency Mitral valve surgery
- Mitral stenosis
- Paradoxical septal motion