Background
Patients and methods
Statistical analysis
Preoperative patient characteristics | Small LV group (N = 86) | Normal or dilated LV group (N = 98) | P-value |
---|---|---|---|
Age (years) | 34 ± 7 | 35 ± 8 | 0.02 |
Gender | |||
Males/Females | 36 (42%)/ 50 (58%) | 46 (47%)/ 52 (53%) | 0.49 |
Body surface area (m2) | 1.68 ± 0.12 | 1.71 ± 0.16 | 0.15 |
Chronic AF | 58 (67%) | 68 (69%) | 0.78 |
Previous CVS | 18 (21%) | 25 (25.5%) | 0.46 |
Previous balloon commisurotomy | 24 (28%) | 37 (38%) | 0.16 |
Co-morbidities | |||
Diabetes mellitus | 6 (7%) | 8 (8%) | 0.76 |
Systemic hypertension | 5 (5.8%) | 3 (3%) | 0.36 |
COPD | 2 (2%) | 2 (2%) | 0.89 |
Residual hemiparesis after previous CVS | 4 (4.6%) | 6 (6.1%) | 0.66 |
CRF on regular dialysis | 1 (1.16%) | – | 0.46 |
Preoperative Echocardiographic date | |||
Mean LVEDD (cm) | 4.94 ± 0.80 | 5.51 ± 1.70 | 0.002 |
Mean LVESD (cm) | 3.35 ± 0.18 | 3.54 ± 0.30 | 0.001 |
Mean LVEDV index (ml/m2) | 34.48 ± 2.7 | 65.67 ± 3.4 | 0.001 |
Mean mitral valve area (cm2) | 0.61 ± 0.20 | 0.62 ± 0.60 | 0.14 |
Mean PG across the mitral valve (mmHg) | 20.68 ± 2.56 | 20.03 ± 2.36 | 0.08 |
Degree of associated mitral regurgitation | 0.001 | ||
≤ + 1 | 75 (87%) | 8 (8%) | |
≤ + 2 | 11 (13%) | 90 (92%) | |
Mean left atrial diameter (cm) | 5.12 ± 0.58 | 5.28 ± 0.61 | 0.07 |
Mean pulmonary artery pressure (mmHg) | 54.17 ± 9.08 | 51.78 ± 9.60 | 0.08 |
Evidence of left atrial thrombus | 5 | 7 | 0.72 |
Results
Preoperative characteristics
Operative data
Operative data | Small LV group (N = 86) | Normal or dilated LV group (N = 98) | P-value |
---|---|---|---|
Pathology of MS | 0.76 | ||
Rheumatic | 84 (98%) | 95 (97%) | |
Degenerative | 2 (2%) | 3 (3%) | |
Techniques of MVR | 0.50 | ||
Full median sternotomy | 35 (41%) | 36 (37%) | |
Lower ministernotomy | 15 (17%) | 18 (18%) | |
Right anterolateral minithoracotomy | 36 (42%) | 44 (45%) | |
Sizes of mitral prostheses (mm) | 0.50 | ||
25 | 2 | 1 | |
27 | 80 | 89 | |
29 | 4 | 8 | |
Intra-operative time parameters (min) | |||
Total operative time | 219.25 ± 19.86 | 213.70 ± 22.12 | 0.07 |
CPB time | 85.67 ± 7.72 | 83.43 ± 8.06 | 0.06 |
Cross-clamp time | 67.80 ± 10.23 | 69.37 ± 9.21 | 0.27 |
Need for inotropic support | 80 (93%) | 60 (45%) | 0.01 |
Need for IABP due to low COP syndrome | 6 (7%) | 1 (1%) | 0.03 |
Postoperative results
Postoperative results | Small LV group (N = 86) | Normal or dilated LV group (N = 98) | P-value |
---|---|---|---|
Duration of mechanical ventilation (hours) | 6.46 ± 1.38 | 6.08 ± 1.36 | 0.06 |
Duration of ICU stay (days) | 3.76 ± 1.05 | 3.48 ± 1.08 | 0.07 |
Total hospital stay (days) | 8.87 ± 1.18 | 8.59 ± 0.90 | 0.07 |
Postoperative complications | |||
Renal failure | 2 (2.5%) | 3 (3%) | 0.75 |
Cerebrovascular stroke | – | 1 (1%) | 0.53 |
Heart failure | 10 (11.6%) | 2 (2%) | 0.008 |
Re-exploration for bleeding | 1 (1.16%) | – | 0.47 |
In-hospital mortality | 3 (3.4%) | – | 0.10 |