title: An excellent result of surgical treatment in patients with severe pulmonary arterial hypertension following mitral valve disease.
abstract: OBJECTIVE
  Observe the efficacy of surgical treatment in patients with severe pulmonary arterial hypertension caused by mitral valve disease.
  
  
  METHODS
  We examined the results of surgical treatment in 32 patients with mitral valve disease and severe pulmonary arterial hypertension (pulmonary arterial systolic pressure ≥ 80 mmHg) retrospectively. Operative and postoperative data collection included type of the surgery, cardiopulmonary bypass time, cross-clamp time and the mortality rate. Pulmonary arterial systolic pressure, left atrial diameter, left ventricular end-diastolic diameter, and left ventricular ejection fraction were recorded and compared.
  
  
  RESULTS
  A total number of 32 patients had the operation of mitral valve replacement. Among those subjects, twenty-seven patients were surgically replaced with mechanical prosthesis and five patients with tissue prosthesis. Only one patient died of pneumonia, with a mortality rate of 3.1 %. The statistical results of preoperative and postoperative echocardiographic data showed significant decrease in pulmonary arterial systolic pressure (101.2 ± 20.3 versus 48.1 ± 14.3 mmHg, P < 0.05), left atrial diameter(67.6 ± 15.7 versus 54.4 ± 11.4 mm, P < 0.05) and left ventricular end-diastolic diameter (52.3 ± 9.5 versus 49.2 ± 5.9 mm, P < 0.05). There was no significant change in left ventricular ejection fraction (59.2 ± 6.5 versus 57.9 ± 7.6, P = NS). At the time of follow-up, twenty-eight (96.6 %) patients were classified in New York Heart Association functional class I or II, one(3.4 %) in class III, with the mortality rate is zero percent.
  
  
  CONCLUSIONS
  Mitral valve replacement can be performed successfully in patients with mitral valve disease and severe pulmonary arterial hypertension with an acceptable perioperative risk.
authors.affiliation: Department of Intensive Care Unit (ICU), Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. xiaochunsong@sina.com.cn.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Intensive Care Unit (ICU), Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. zhangcui1967@163.com.
authors.forename: Cui
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. xinchen1963@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Intensive Care Unit (ICU), Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. yongmingchen1980@163.com.
authors.forename: Yongming
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Intensive Care Unit (ICU), Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. qiankunshi1975@163.com.
authors.forename: Qiankun
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Department of Intensive Care Unit (ICU), Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. yongshengniu1972@163.com.
authors.forename: Yongsheng
authors.initials: Y
authors.lastname: Niu
authors.affiliation: Department of Intensive Care Unit (ICU), Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. xiaojilai1978@163.com.
authors.forename: Jilai
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Intensive Care Unit (ICU), Nanjing Hospital Affiliated to Nanjing Medical University, Qinhuai district, No. 68 Changle Road, Nanjing, 210006, Jiangshu, China. muxinwei1964@163.com.
authors.forename: Xinwei
authors.initials: X
authors.lastname: Mu
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016277:Ventricular Function, Left