Clinical Study On Left Ventricular Remodeling After Mitral Valve Replacement

Objective:In this study we have 58 patients with rheumatic mitral valve disease (mitral stenosis or mitral insufficient) underwent merely Mitral Valve Replacement(MVR). Through information from their preoperative, postoperative and long-term ultrasonic cardiogram results (left ventricular dimension and left ventricular ejection fraction),we compare their differences, to analyze post operative left ventricular remodeling of different mitral valve lesion type(MS& MI) and conclude clinical experience.Methods:From August 2002 to August 2015,58 cases were selected. All cases were divided into to groups according to their main mitral valve lesion type,36 MS patients as Group A while 18 MI patients as Group B. In order to compare preoperative, postoperative and long-term data including LVD and LVEF, we obtain these data by ultrasonic cardiogram before or after MVR within 1 week. And data mentioned above was also taken in long-term follow-up. We adopt "Paired-t-test" to compare the data (LVD or LVEF) of patients belonging to same group.Results:All patients were operated successfully and discharged from hospital In patients with mitral stenosis (Group A), short-term postoperative LVD (42.76 ±5.50mm)and LVEF (62.19%±7.05%)had no significant change compared with preoperative(LVD 43.63±5.55mm;LVEF 61.58%±6.51%, P>0.05). Long term follow-up data of Group A showed that the LVD was increased (47.47±3.31mm,P<0.05), and LVEF was significantly increased (66.22%±4.4%, P<0.05). In patients with mitral regurgitation (group B), LVD(58.21±9.09mm) was significantly decreased after operation(51.29±7.56mm,P<0.05),but postoperative LVEF(59.08%±7.42%) had no significant changes compared with the preoperative(61.25%±8.37%,P>0.05). Long term follow-up data of Group B show the LVD compared with the preoperative have significantly reduced (47.25±5.05mm,P<0.05), long-term follow-up LVEF compared with preoperative LVEF show no significant change (61.92%±3.75%,P>0.05), but the long-term follow-up of LVEF was significantly improved compared with the postoperative (P<0.05).Conclusion:1. LVD and LVEF were maintained at the same level in the near future after MVR in MS patients. The long-term postoperative LVD was increased, and the LVEF was significantly enhanced compared with preoperative.2. LVD was decreased in short-term after MVR operation in patients with mitral regurgitation and LVEF was maintained at the same level. Long term left ventricular further decreased and LVEF was improved in the near future.3. Left ventricular remodeling after MVR in MS patients was more significantly in the long term. As for patients with MI, left ventricular geometry is changed obviously after MVR operation and the left ventricle has a further remodeling process in the long term.