Shantanu Pande, Surendra K. Agarwal, Sudeep Kumar, Ram K. Shukla, Nishant Tripathy, Ravi K. Singh, Nakul Sinha Departments of Cardiovascular and Thoracic Surgery and Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India |
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Background and aim of the study: Acute mitral regurgitation (MR) may cause adverse hemodynamics following mitral balloon valvotomy (MBV). Some patients become severely hemodynamically unstable and require emergency mitral valve replacement (MVR), while others remain relatively stable with medical management. The study aim was to identify factors that would predict severe acute MR leading to severe hemodynamic compromise requiring |
ventricular systolic pressure (RVSP) before and after MBV was significantly higher, and a significantly higher level of calcium was present in the mitral valve leaflets. Univariate analysis of the RVSP before and after MBV predicted the occurrence of hemodynamic instability leading to emergency MVR. The receiver operating characteristic (ROC) curve for RVSP before and after MBV had a significant area under the curve (0.944, p <0.005 and 0.940, p <0.005, respectively). Based on the ROC data, the pre- and post-MBV RVSPs of 76 mmHg and 77 mmHg, respectively, predicted the possibility of emergency MVR, with sensitivities and specificities of 72% and 63%, and 100% and 90%, respectively. |
Factors Predicting Emergency Surgery in Severe Mitral Regurgitation Following Mitral Balloon Valvotomy |
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