Effect of pulmonary hypertension on short- and long-term mortality in patients with severe mitral stenosis undergoing mitral valve replacement

Abstract

　Background: Previous reports have shown that pulmonary hypertension has negative effects on operative mortality in patients with mitral regurgitation undergoing mitral valve replacement. However, the effect of pulmonary hypertension in patients with mitral stenosis has not been clarified. This retrospective study aimed to determine the effect of preoperative pulmonary hypertension on short- and long-term mortality in patients with severe mitral stenosis undergoing mitral valve replacement.

　Method: Sixty-nine patients with severe mitral stenosis were enrolled. Patients were divided into two groups by preoperative systolic pulmonary artery pressure/systolic blood pressure ratio with a cut-off value of 0.3. Postoperative 30-day mortality and long-term mortality were compared between the groups.

　Result: Forty-nine (71%) patients were in the PH group. Four (5.8%) patients died during the perioperative period. Operative mortality was comparable between the groups (6.1% in the PH group vs. 5% in the non-PH group, p=1.0). Eighteen (26.1%) patients died in the long-term period and mortality was comparable between the groups (30.6% vs. 15%, p=0.24). Neither logistic regression analysis nor Cox regression analysis showed a significant association between the presence of pulmonary hypertension and mortality (adjusted odds ratio: 1.12, 95% confidence interval: 0.08-15.2, p=0.93 and adjusted hazard ratio: 1.91, 0.49-7.44, p=0.35, respectively).

　Conclusion: There is no significant association between pulmonary hypertension and short- and long-term mortality in patients with severe mitral stenosis undergoing mitral valve replacement.