Application value of echocardiography in the evaluation of surgical efficacy of rheumatic mitral valve disease

Li Xiaoming; Zhang Wenbo; Du Yue; Wang Jiangang; Zhang Chun

doi:10.3760/j.issn.1673-4777.2025.04.005

Abstract：Objective To explore the application value of echocardiography in evaluating the improvement of cardiac structure and hemodynamic status after rheumatic mitral valve disease surgery.Methods From March 2012 to June 2023,a total of 112 patients with rheumatic mitral stenosis and/or mitral regurgitation who underwent mitral valve replacement or mitral valve repair in Beijing Anzhen Hospital,Capital Medical University and underwent echocardiography review after operation were retrospectively enrolled.The cardiac structure and function indexes before and after operation were compared to evaluate the postoperative clinical efficacy.Results The mean age of 112 patients was(69±3)years,90 patients(80.4％)were female.75 patients(67.0％)underwent mitral valve replacement,37 patients(33.0％)underwent mitral valve repair,and 93 patients(83.0％)underwent tricuspid valve repair at the same time.The median follow-up time was 32(13,62)months.The diameters of bilateral atria and left atrial anteroposterior diameter after operation were significantly smaller than those before operation(all P＜0.001).The amplitude of ventricular septal motion after surgery was significantly smaller than that before surgery,the area of mitral valve orifice was significantly larger than that before surgery,and the area of mitral regurgitation was significantly smaller than that before surgery[(5±2)mm vs(7±2)mm,(2.3±0.4)cm2 vs(1.3±0.5)cm2,2.7(1.9,3.8)cm2 vs 6.0(2.3,10.0)cm2](all P＜0.05).Postoperative pulmonary artery systolic pressure,tricuspid regurgitation pressure gradient,tricuspid regurgitation peak velocity and tricuspid regurgitation area were significantly lower than those before operation(all P＜0.001).Conclusions Mitral valve replacement or repair can significantly improve the cardiac structure and hemodynamic status of patients with rheumatic mitral valve disease.Echocardiography is an important tool to evaluate the effect of surgery.