The Impact of Concomitant Pulmonary Hypertension on Early and Late Outcomes Following Surgery for Mitral Stenosis

Abstract Objectives Initial evidence is provided on management of mitral stenosis and pulmonary hypertension based on short- and long-term outcomes following mitral surgery. Methods From 1992-2014, consecutive mitral stenosis patients (n=317) with known pulmonary artery pressure having undergone mitral surgery were reviewed. Pulmonary hypertension severity, based on pulmonary artery systolic pressure, was categorized as mild, 35 to 44 mmHg; moderate, 45 to 59 mmHg; and severe, >60 mmHg. Primary outcomes were 30-day mortality and long-term survival. Results No significant group differences for age or pre-operative comorbidities. Mitral surgery included mitral valve replacement (78%) and repair (22%). The severe pulmonary hypertension group had more mitral valve replacement (81%, p=0.04), severe tricuspid valve regurgitation (31%, p=0.003), right heart failure (17%, p=0.02), and concomitant tricuspid valve procedures (46%, p