Abstract 225: The Protective Role of Mitral Valve Surgery on Right Ventricular Reverse Remodeling
Objectives: Mitral valve surgery is known to benefit left ventricular reverse remodeling. The aim of this study was the follow up of right ventricular remodeling with real time three dimensional echocardiography of patients undergoing mitral valve surgery.
Methods: 31 patients with severe mitral regurgitation who underwent mitral valve surgery constituted the study cohort. All patients had a baseline and a 6-month follow up scan with two and real time three-dimensional echocardiography. Right ventricular (RV) volumes (end-diastolic: EDV, end-systolic: ESV, stroke volume: SV), function (ejection fraction: EF) and mass (M) were measured with the method of summation of disks. Results had a normal distribution and they were expressed as mean ± standard deviation (SD). Systematic differences in measurements were assessed with Student t-test. Analysis was performed with SPSS 13.0 and a p value of <0.05 was considered significant.
Results: Mean age was 52.6±14.8 years and 19 patients (61.3%) were women. 24 patients (77.4%) had degenerative disease while 7 patients (22.6%) endocarditis. Furthermore, 21 patients (67.7%) underwent mitral valve repair (MVrep) and 10 patients (32.3%) replacement (MVR). There was a significant reverse remodeling after mitral valve surgery in all patients, except RV mass: RV-EDVpre: 102.4±ml vs RV-EDVpost: 92.42 ml, p<0.05/RV-ESVpre: 33.6 ml vs RV-ESVpost: 25.8 ml, p<0.05, RV-SVpre: 75±15.4 ml vs RV-SVpost: 69.9±10.2, p<0.05, RV-EFpre: 70±8.7% vs RV-EFpost: 72.9±6%, p<0.05, RV-Mpre: 65.5±19 gr vs RV-Mpost: 68.3±18.3 g, p=0.24. When patients were compared according to the type of the operation, there was no significant difference between the RV reverse remodeling, as it is demonstrated in table 1.
Discussion: Mitral valve surgery benefits RV reverse remodeling within the first 6 months, possibly due to the reduction of left ventricular filling pressure and direct intraventricular dependence. Despite that, there is no difference between mitral valve replacement and repair.