Extreme pulmonary hypertension caused by mitral valve disease. Natural history and results of surgery

Abstract

Five hundred and eighty six patients with mitral valve disease were studied with cardiac catheterization between 1961 and 1972; 48 (8.2%) had extreme pulmonary hypertension (resting systolic pulmonary artery pressure of 80 mmHg or above and pulmonary vascular resistance of 10 units or greater) and of these patients, 27 underwent cardiac surgery. The operative mortality for mitral valvotomy was 11% and for mitral valve replacement 50%. The overall mortality was 31%. The risks of operation were increased in those with a long history of cardiac symptoms, those over 50 years of age, and in the presence of associated aortic valve disease. The mean survival for those patients not having operation was only 2.4±0.5 years. The mean follow up period for those surviving operation has been 5.8±0.6 years, and symptomatic improvement has been good.