Perspective Directions in Management of Severe Group Two Pulmonary Hypertension

Purpose. To compare immediate results of mitral valve surgery in patients with severe pulmonary hypertension with versus without concomitant pulmonary artery denervation. Materials and methods. From January to December 2015 30 patients were randomly assigned into two groups. Patients of one group underwent mitral valve surgery (comparison group), in the other group mitral valve surgery was accompanied by pulmonary artery ablation (ablation group). Both groups had comparable anthropometric, echocardiographic, and hemodynamics characteristics. Results. There were no hospital mortality and specific ablation-related complications. Left ventricular remodeling and decrease of pulmonary artery pressure were observed in both groups at discharge. On the third day after surgery systolic and mean pulmonary artery pressure assessed by right heart catheterization were 48 and 22 versus 59 and 39 mm Hg in ablation and comparison group, respectively (p<0.05). No significant improvement of results of six-minute walk test was registered at discharge in both groups. Conclusions. Concomitant radiofrequency pulmonary artery ablation in patients with mitral valve disease and severe pulmonary artery hypertension was associated with lower pulmonary artery pressure in early postoperative period in comparison with valve surgery alone.

легочная гипертензия, абляция легочной артерии, митральные пороки сердца, pulmonary hypertension, pulmonary artery ablation, mitral valve disease

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