Preoperative Pulmonary Artery Systolic Pressure and Survival in Patients Undergoing Valve Replacement for Mitral Stenosis

Abstract

Introduction: High pulmonary artery pressure (PAP) is a critical survival parameter in patients with severe mitral stenosis. We investigated changes in PAP and their impact on survival in patients undergoing mitral valve replacement for severe mitral stenosis. Methods: We retrospectively analyzed 42 patients who underwent mitral valve replacement for severe mitral stenosis between January 2020 and January 2022. Changes in systolic pulmonary artery pressure (sPAP) assessed by echocardiography and survival outcomes were analyzed. Results: The mean age of the patients was 56.05±14.21 years. Among the patients, 71.4% were female and 28.6% were male. The median postoperative sPAP was 29 mmHg, which was significantly lower than the preoperative value (p<0.001). In the subgroup analysis according to preoperative sPAP value, the postoperative sPAP change was 17.87% in <50 mmHg group and 41.61% in ≥50 mmHg group, which indicated a statistically significant difference (p=0.003). In the patient group with preoperative sPAP <50 mmHg, the expected 3-year survival rate was 85.2% compared with 75.8% in the patient group with sPAP ≥50 mmHg, and the differences were insignificant (p=0.510). Conclusion: Patients with severe mitral stenosis and high sPAP can undergo surgery with acceptable survival expectancy. However, the decrease in pulmonary pressure in the early postoperative period alone cannot adequately predict survival.

Keywords

• mitral stenosis
• mitral valve
• pulmonary artery
• survival rate