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Abstract
Background and objectives: Severe pulmonary hypertension (PH) is a known risk factor in valvular surgery. In the present study, we investigated the impact of preoperative pulmonary hypertension on early outcomes after mitral valve replacement. Methods: Fifty patients undergoing mitral valve replacement divided into two groups, group (A): mitral valve replacement with mild to moderate pulmonary hypertension. group (B): mitral valve replacement with severe pulmonary hypertension. PH was classified as none (sPAP<40 mm Hg), mild (40{u2264}sPAP<50 mm Hg), moderate (50{u2264}sPAP<60 mm Hg), or severe (sPAP{u2265}60 mm Hg). Results: group (A) patients with mild to moderate pulmonary hypertension (40{u2264}sPAP<60 mm Hg) showed intraoperative less aortic cross clamp time ( mean ±SD 37.56±6.21), less total cardiopulmonary bypass time (mean ±SD 48.96±7.27) and 72% of patients weaned from cardiopulmonary bypass smoothly without inotropic support, while group (B) patients with severe pulmonary hypertention (sPAP{u2265} 60 mm Hg up to 100 mm Hg the maximal value of pulmonary hypertension in our study patients) showed more aortic cross clamp time (mean ±SD 49.52±6.93), more total cardiopulmonary bypass time (mean ±SD 62.40±7.35) and 64% of patients weaned from cardiopulmonary bypass on inotropic support. The ICU course, group (A) patients with mild pulmonary hypertention required lesser time on mechanical ventilation (mean ±SD7.60±1.73) than group (B) patients with severe pulmonary hypertention mean ±SD 13.16±8.26