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Changes in Right Ventricle Function After Mitral Valve Repair Surgery
Sam R Orde1, Sheng-Ying Chung2, Juan N Pulido3
1Department of Cardiovascular Diseases, Rochester, MN, USA; Nepean Hospital, Sydney, NSW, Australia.
Heart, Lung & Circulation
|July 30, 2019
Summary
Minimally invasive robotic-assisted mitral valve repair (MIMVr) shows less right ventricular (RV) dysfunction after surgery compared to standard repair. RV function recovers better at one year with MIMVr, though not fully to pre-surgery levels.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Right ventricular (RV) dysfunction is a known complication following cardiac surgery, potentially persisting long-term.
- Assessing perioperative RV systolic function is crucial, especially in patients undergoing mitral valve (MV) repair.
- Minimally invasive robotic-assisted mitral valve repair (MIMVr) is compared against standard open mitral valve repair (MVr).
Purpose of the Study:
- To evaluate and compare perioperative right ventricular (RV) systolic function in patients undergoing minimally invasive robotic-assisted mitral valve repair (MIMVr) versus standard open mitral valve repair (MVr).
- To assess the impact of different mitral valve repair techniques on RV function using speckle tracking echocardiography.
Main Methods:
- Retrospective analysis of 158 patients undergoing MV repair over three years.
- Utilized transthoracic echocardiograms (preoperative, pre-discharge, and 1-year follow-up) to measure RV free wall strain (RVS).
- Speckle tracking echocardiography was employed as a sensitive method for assessing RV systolic function.
Main Results:
- RV free wall strain (RVS) significantly declined after both MV repair procedures.
- MIMVr demonstrated smaller reductions in RVS compared to MVr, indicating less RV systolic dysfunction.
- Enhanced RV functional recovery was observed at 1-year follow-up in the MIMVr group compared to the MVr group, even after adjusting for baseline values and other clinical factors.
Conclusions:
- Right ventricular systolic dysfunction is a common occurrence after mitral valve repair surgery.
- Minimally invasive robotic-assisted mitral valve repair (MIMVr) is associated with less pronounced RV contraction deterioration and better functional recovery at one year compared to standard MVr.
- While RV function may not fully return to preoperative levels, the findings suggest potential clinical functional benefits with MIMVr, warranting further investigation.
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