Mitral Stenosis Patients With Small Left Ventricle: Analysis Of Influence Factors And Postoperative Clinical Characteristics

Objective:To explore the related factors of small left ventricle in patients with MS and their clinical characteristics af-ter mitral valve replacement.Methods:MS patients who underwent mitral valve replacement in the Department of Cardiovascular Surgery,Second Xiangya Hos-pital of Central South University from January 2019 to December2021 were collected,and the general clinical data of the patients were recorded.Biochemical examination,echocardiography data,vasoactive inotropic score,ventilator time,ICU time,IABP,atrial fibrillation,complications,24 hours,48 hours after operation and the last biochemical examination before discharge,postoperative echocardiography data,length of stay.According to the standard of LVEDVI≤50m L/m~2,the patients were divided into small left ventricle group and non-small left ventricle group.The preopera-tive indexes were analyzed by multivariate analysis,and the post-operative indexes were compared after the tendency score was matched.Results:A total of 284 patients were included in this study,in-cluding 66 patients(23%)in MS with small left ventricle group and 218 patients(77%)in non-small left ventricle group.The age of MS with small left ventricle group was younger than that of non-small left ventricle group.The incidence of diabetes in pa-tients with MS with small left ventricle was significantly higher than that of patients with non-small left ventricle.LVEDD and LVEDV in MS with small left ventricle group were significantly lower than those in non-small left ventricle group,but EF was higher than that in non-small left ventricle group.Multivariate analysis showed that age and diabetes were significantly corre-lated with left ventricular decrease in patients with MS.The time of ventilator use and the score of vasoactive drugs 12 hours after mitral valve replacement in patients with MS and small left ven-tricle were significantly higher than those in patients with non-small left ventricle.White blood cell in patients with MS compli-cated with small left ventricle at 24 hours,48 hours and at dis-charge after mitral valve replacement.The neutrophil at 48 hours after operation and at discharge was significantly higher than that in the non-small left ventricle group(P<0.05).Conclusion:Diabetes is a risk factor for small left ventricle in patients with MS.Compared with patients with non-small left ven-tricle,MS patients with small left ventricle need more respiratory and cardiac support after operation,in MS patients with small left ventricle,the left ventricle can recover to nearly normal size in the early stage after operation.