Operative procedure:
In all the 265 patients who underwent MVR, 195 of them had severe PHT . All of them had the classical left atrial approach through Sondergaard’s groove incision except 11 cases which was approached through the septum after opening the right atrium. All cases were operated through the standard median sternotomy and were done using cardiopulmonary bypass utilizing cardioplegic arrest to open the chamber (s) (Figure 2). In about 195 out of 265 patients (73.58%), MVR was done with either partial or complete chordal preservation. All the patients had St Jude’s mechanical prosthetic valve (Figure 2).
Except for the 14 deaths which occurred due to low cardiac output failures, all other cases were weaned of the ventilator by day 1 and from the inotropic supports by day 2 or day 3.Those patients who had severe Pulmonary Hypertension who underwent MVR were followed up using echo at day 0, 3 months and 6 months.