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Postoperative changes in left ventricular systolic function after combined mitral and aortic valve replacement in

Sang-Mee An1, Jae-Sik Nam2, Ho Jin Kim3

  • 1Department of Anesthesiology and Pain Medicine, Ewha Womans University Seoul Hospital, Seoul, South Korea.

Journal of Cardiac Surgery
|July 12, 2021
PubMed

Insights

In rheumatic heart disease (RHD) patients undergoing valve replacement, left ventricular ejection fraction (LVEF) initially stabilizes. Long-term LVEF trends differ based on preoperative function, showing a plateau in normal LVEF and a decline in reduced LVEF.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Rheumatic heart disease (RHD) affects heart valves, often necessitating combined aortic and mitral valve replacement.
  • Postoperative left ventricular systolic function is crucial for patient outcomes after valve surgery.

Purpose of the Study:

  • To investigate short- and long-term changes in left ventricular systolic function after combined aortic and mitral valve replacement in RHD patients.
  • To compare these changes based on preoperative left ventricular ejection fraction (LVEF).

Main Methods:

  • Analysis of 146 RHD patients undergoing combined valve replacement.
  • Stratification into two groups based on preoperative LVEF: ≥50% (n=113) and <50% (n=33).
  • Utilized a restricted cubic spline model to analyze time-dependent changes in echocardiographic parameters.

Main Results:

  • No significant difference in LVEF was observed preoperatively or immediately postoperatively before discharge.
  • In patients with preoperative LVEF ≥50%, LVEF slightly increased and plateaued during a median follow-up of 3.2 years.
  • In patients with preoperative LVEF <50%, LVEF increased over 3-4 years before gradually declining (p < .001).

Conclusions:

  • Long-term postoperative LVEF demonstrates a downward trend in RHD patients with initially reduced LVEF.
  • In RHD patients with normal preoperative LVEF, long-term postoperative LVEF tends to stabilize or plateau.
Abstract

Keywords:
double valve replacementleft ventricular ejection fractionrheumatic heart disease

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