Clinical experience with Sorin Bicarbon valve in patients with tight mitral valve stenosis and elevated pulmonary hypertension (early and mid-term results).

BACKGROUND

The results of mitral valve replacement (MVR) with Sorin mechanical valves in patients who had tight mitral stenosis with high pulmonary artery pressure were reviewed.

METHODS

During a period of two years, from August 1998 to May 2000, a mitral valve replacement with a Sorin Bicarbon mechanical valve was performed in 51 patients with a diagnosis of tight mitral stenosis associated with severe pulmonary hypertension (preoperative mean systolic pulmonary artery pressure was 72+/-12 mmHg, range from 60 to 105 mmHg). There were 37 women and 14 men; mean age was 47.2+/-12 years. Forty-eight patients (94.12%) were in NYHA functional class III or IV. All the patients discharged from the hospital were submitted to a clinical follow-up program. A 100% follow-up was obtained with a mean of 12.6+/-6.4 months (range 2 to25 months).

RESULTS

Operative mortality was 3.9%, 2 patients who had concomitant CABG died due to low cardiac output. Twelve patients (23.5%) needed an inotropic pharmacological support during the postoperative time. In one patient a re-exploration for bleeding was necessary, and in another one a cerebrovascular accident occurred 3 days after the operation. After 6 months, one patient was reoperated on because of mechanical valve dysfunction due to pannus formation. All survivors underwent a postoperative echocardiographic assessment. The systolic PAP decreased from a mean preoperative value of 72+/-12 mmHg to 39.9+/-12 mmHg. NYHA functional status significantly improved and 86% of the patients were in NYHA functional class I or II.

CONCLUSIONS

The mitral valve replacement with Bicarbon mechanical valve prosthesis shows excellent results in patients with mitral valve stenosis associated with a severe pulmonary hypertension.