EFFECTS OF MITRAL-VALVE REPLACEMENT ON THE PULMONARY VASCULAR DYNAMICS OF PATIENTS WITH PULMONARY HYPERTENSION

Cardiac catheterization studies after combined tricuspid, mitral, and aortic valve replacement

Postoperative cardiac catheterizations were performed in eight patients within the first year following replacement of the tricuspid, mitral, and aortic valves with Starr-Edwards ball-valve prostheses. Two additional patients were studied who had mitral and tricuspid replacement. Before surgery the patients characteristically had distinct elevation of right and left atrial pressures, and markedly reduced cardiac outputs. Four individuals had marked pulmonary hypertension. At the postoperative catheterizations, consistent changes were an increase in cardiac output, a decrease in right and left atrial pressures, and a decrease in right ventricular systolic pressure. The last change was particularly notable in those individuals who had marked pulmonary hypertension before surgery.