Outcome And Predictive Factors Of Mild Or Mild To Moderate Functional Mitral Regurgitation After Aortic Root Surgery

Objective: To summarize the outcome of aortic root disease with mild or moderate functional mitral regurgitation after Aortic Root Surgery.To explore the predictors of the improvement of functional mitral regurgitation in these patients.Methods: The clinical data of patients with aortic root disease complicated with mild or mild to moderate functional mitral regurgitation diagnosed by transaortic CTA and cardiac ultrasound in the Department of Cardiac Surgery of our hospital from January 2015 to June 2019 were collected.The datas are including age,weight,gender,past medical history,imaging results,laboratory test results and relevant examination data.Through the cardiac ultrasound data,the patients were divided into the improvement group(the degree of postoperative cardiac ultrasound mitral regurgitation decreased or disappeared)and the non-improvement group(the degree of postoperative cardiac ultrasound mitral regurgitation did not change or increased)after comparing the degree of postoperative functional mitral regurgitation.Various data of patients in the two groups were statistically analyzed,and the data with statistical differences were included in the logistic regression model for regression analysis.Results: 1.A total of 43 patients with aortic root disease and mild or mild to moderate mitral regurgitation were included in this study.There were 34 male and 9 female patients with a male to female ratio of 3.8:1,and there was no statistically significant difference in gender between the no-improvement group and improvement group(Fisher's exact test,p = 0.72).2.There were 12 patients with hypertension,accounting for 27.9% of the total,and there was no statistically significant difference in the history of hypertension between the no-improvement group and improvement group(rank sum test,p = 1).3.There were significant differences in preoperative pulmonary arterial pressure(rank sum test,p = 0.007),aortic cross-clamp time(rank sum test,p = 0.03),and cardiopulmonary bypass time(rank sum test,p = 0.04)between the two groups.4.Logistic regression analysis showed that preoperative pulmonary arterial pressure(OR = 1.21,95% CI: 1.07 ~ 1.44,p = 0.01)and aortic cross-clamp time(OR = 1.07,95% CI: 1.01 ~ 1.05,p = 0.01)were risk factors affecting the improvement of mitral regurgitation.Conclusion: 1.The degree of mitral regurgitation was improved in 51.2%(22 / 43)of patients with mild and mild to moderate functional mitral regurgitation after aortic root surgery.2.Long aortic occlusion time and high preoperative pulmonary artery pressure were the predictors of no improvement in mild or mild to moderate functional mitral regurgitation after aortic root surgery.3.It is suggested that when the aortic cross-clamping time is long and the preoperative pulmonary arterial pressure is high,the concomitant mild and mild to moderate functional mitral regurgitation may be considered in the treatment of aortic root disease.