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Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat
08:34

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Mitral stenosis with severe pulmonary hypertension

S S Kabbani1, T Bashour, R Dunlap

  • 1Cardiovascular Surgical Center, Damascus Medical School, Damascus, Syria.

Texas Heart Institute Journal
|September 1, 1982
PubMed

Insights

Severe mitral stenosis can cause high pulmonary artery pressures, leading to pulmonary hypertension or low cardiac output. Surgical intervention offers potential for good long-term outcomes in select patients.

Area of Science:

  • Cardiology
  • Pulmonary Hypertension
  • Valvular Heart Disease

Background:

  • Mitral valve disease is a significant cause of cardiac morbidity.
  • Pulmonary hypertension is a serious complication of mitral stenosis.
  • High pulmonary artery pressures impact patient prognosis and management.

Purpose of the Study:

  • To investigate the clinical presentation and outcomes of patients with mitral stenosis and severe pulmonary hypertension.
  • To evaluate the efficacy of surgical interventions in this patient cohort.

Main Methods:

  • Retrospective analysis of 512 patients with mitral valve disease undergoing catheterization.
  • Identification of 85 patients with mitral stenosis and systolic pulmonary artery pressures >= 100 mm Hg.
  • Review of surgical procedures and perioperative management, including nitroprusside infusion.

Main Results:

  • 85 patients had mitral stenosis with severe pulmonary hypertension (>= 100 mm Hg).
  • Majority presented with New York Heart Association Class IV (51.8%) or Class III (35.3%) symptoms.
  • Pulmonary hypertension symptoms were prominent in 56.5%; low cardiac output syndrome in the remainder.
  • 40 patients underwent surgery (commissurotomy, mitral valve replacement, double valve replacement).
  • Overall operative mortality was 15%; good long-term results in 30 patients.

Conclusions:

  • Mitral stenosis with severe pulmonary hypertension presents with significant symptoms and carries a high operative risk.
  • Surgical management, including valve repair or replacement, can lead to good long-term outcomes in carefully selected patients.
  • Perioperative support, such as nitroprusside infusion, may improve survival in critical cases.

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