Cardiac dimensions and motion shortly after mitral valve surgery.

Publisher Website
Google Scholar
Abstract
Adult patients (71) were studied echocardiographically before and 2-16 days (mean 8) after mitral valve surgery to systematically evaluate the early postoperative changes in cardiac dimensions and motion. The patients were divided into 4 groups: group 1 with predominant mitral stenosis (MS) (26 patients), group 2 with predominant mitral insufficiency (MI) (12 patients), group 3 with MS + MI (16 patients) and group 4 with combined mitral and aortic valvular disease (17 patients). After operation the left atrial dimension at end-systole decreased (mean .+-. SD, 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 end diastole decreased in group 2 from 67 .+-. 12 mm to 54 .+-. 5 mm (P < 0.01) and in group 4 from 59 .+-. 13 mm to 54 .+-. 13 mm (P < 0.01), but increased in group 1 from 43 .+-. 8 mm to 46 .+-. 9 mm (P < 0.05). Mitral EF (ejection fraction) slope increased from 15 .+-. 11 mm/s to 52 .+-. 20 mm/s (P < 0.001) after commissurotomy and decreased from 136 .+-. 61 mm/s to 66 .+-. 30 mm/s (P < 0.05) after annuloplasty. The postoperative means were subnormal in these sub-groups. Paradoxical or hypokinetic septal motion occurred in 5/71 (7%) before and 50/71 (70%) after operation. 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; postoperative abnormal septal motion, which may be caused by pericardiotomy, can occur after any type of open heart surgery.

This publication has 2 references indexed in Scilit: