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The Journal of Cardiovascular Surgery 2002 August;43(4):423-7


lingua: Inglese

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

Erdil N. 1, Çetin L. 1, Nisanoglu V. 2, Demirkilic U. 3, Sener E. 3, Tatar H. 3

1 Department of Cardiovascular Surgery, Alkan Hospital, Ankara, Turkey 2 Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey 3 Department of CVS GATA, Ankara, Turkey


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.

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