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Korean J Anesthesiol > Volume 28(5); 1995 > Article
Korean Journal of Anesthesiology 1995;28(5):640-647.
DOI: https://doi.org/10.4097/kjae.1995.28.5.640   
Changes in Pulmonary Arterial Pressure and Pulmonary Vascular Resistance after Mitral Valve Replacement.
Jeong Seon Han, Yong Woo Hong, Sou Ouk Bang, Chung Hyun Park, Yun Young Choi, Young Seon Sou
1Department of Anesthesiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Korea.
2Department of Anesthesiology, Aju University College of Medicine, Korea.
Abstract
As the mitral valve disease becomes long-standing, the patient may develop pulmonary hypertension. It was reported that after surgical correction, the elevated pulmonary vascular resistance(PVR) would fall quickly in association with the fall in left atrial pressure(LAP). This study was performed to evaluate the changes in mean pulmonary artery pressure(PAP) and PVR immediately after mitral valve replacement(MVR). Fifty six patients undergoing mitral valve replacement(MVR) were divided into two groups on the basis of the presence or absence of significant pulmonary hypertension, defined as a resting mean pulmonary arterial pressure greater than 30mmHg. After induction of anesthesia, PAP, PVR, cardiac output(CO) were measured and compared with values in postbypass period. PAP and PVR were significantly decreased(PAP from 39.64+/-1.88 to 29.18+/-1.65 mmHg, P 0.001, PVR from 6.16+/-1.14 to 3.53+/-0.62 units, P<0.05) in Group II(PAP> or = 30mmHg, n=23), whereas not changed in Group I(PAP30 mmHg, n=33)(P<0.05). Persistance of an elevated PVR may cause right ventricular failure and low-output syndrome, so that an attempt to reduce the PVR is needed postoperatiavely. This study demonstrated that the PAP and PVR fall significantly after MVR especially in patients with severe pulmonary hypertension.
Key Words: Mitral valve replacement; Pulmonary arterial pressure; Pulmpnary vascular resistance
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