Predictors of Right Ventricle Function Improvement in Patients with Right Ventricle Dysfunction after Mitral Valve Surgery
Author : W.M. Saragih, A.S. Kuncoro, R. Zahara, A. M. Soesanto
Upload Date : 19-04-2018
Background: In patients undergoing mitral valve surgery, right ventricular function may decline immediately after the surgical procedure. This condition may sometimes remain, but may also improve later on. Many factors have been proposed to account for this phenomenon.
Objective: This study aims to identify factors that may be predictors of right ventricular function improvement in patients with right ventricular dysfunction following mitral valve surgery.
Methods: This is a retrospective cohort study, taking place at National Cardiovascular Center Harapan Kita (NCCHK), Jakarta, Indonesia. Subjects are patients who underwent mitral valve surgery between January 2016 until February 2017. Data taken include basic characteristics, surgical data, drugs prescribed after surgery, and echocardiography data before surgery, predischarge, and six months after surgery.
Results: There are 100 subjects who fulfilled the criteria to participate in this study. There are 68 (68%) cases of right ventricular function improvement and 32 (32%) cases without improvement. The median of predischarge TAPSE increases significantly six months after surgery, from 1,1 (0,6-1,5) to 1,4 (0,7-2,8) with p value <0,001. No significant association between factors and right ventricular function improvement was found in this study. Analysis of data subset revealed that median of percentage of TAPSE increase was higher in patients receiving: RAA inhibitor [38 ,4 (-27 - 300) versus 20 (-22 – 133,3)], beta blocker [40,8 (-27 - 300) versus 17,8 (-23 – 155,5)], aldosterone antagonist [32,5 (-27 - 300) versus 32 (-23 -155,5)], and pulmonary artery dilator [43 (-23 - 142,8) versus 29,6 (-27 - 300)]. This phenomenon was not seen in those receiving digoxin [27,2 (-27 - 100) versus 38,4 (-23 - 300)]. But these results are not significant statistically.
Conclusion: There is a significant improvement of right ventricular function six months after mitral valve surgery. There are no factors in this study that predict right ventricle function improvement six months after surgery.
KEYWORDS : Right Ventricle Function, Mitral Valve Disease, Mitral Valve Surgery, Predictors, Function Improvement
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