Mitral valve replacement in patients with left ventricle systolic dysfunction

The authors presented immediate results of mitral valve replacement (MVR) for mitral stenosis (MS) in patients with left ventricle systolic dysfunction (LV SD). Since January 2000 till October 2008, in Novosibirsk Federal State Research Institute of Circulation Pathology 38 patients with low (? 50%) LV ejection fraction underwent MVR for MS. There were no coronary artery disease. Those patients formed (n = 38). The control group (II group, n = 49) consisted of patients with normal ejection fraction (EF) undergone MVR for MS. Mean EF in I group was 47%, in II group it was 62%. Hospital mortality in I group was 2.6% (1 patient, died of multiorgan failure), in control group - 2.0% (1 patient, LV posterior wall rupture). There were higher incidence of in-hospital heart failure in I group (24.3% and 8.3% correspondingly, p = 0.04). Our experience of MS surgery in patients with low EF LV showed that in spite of higher incidence of heart failure early after operation, there were no significant difference in hospital mortality and postoperative heart chambers remodeling in patients with LV SD compared to the control group. Thereby LV SD is no contraindication for MVR in patients with mitral stenosis.