Clinical Effect of Iloprost on Pulmonary Artery Hypertension After Mitral Valve Surgery

Abstract

Introduction: Pulmonary arterial hypertension (PAH) is an important risk factor for increased mortality and morbidity during mitral valve surgery. In this study, we analysed the haemodynamic effects of the prostaglandin analogue iloprost in patients with PAH. Patients and Methods: We retrospectively analysed patients with PAH who were undergoing mitral valve surgery and had received intravenous iloprost therapy at our hospital from 1 January 2003 to 31 March 2013. Systemic and pulmonary arterial pressures were measured with catheterisation. The haemodynamic parameters were administered preoperatively and at 0 hours and 24 hours postoperatively. Results: A total of 135 patients had undergone mitral valve operations, of whom 78 patients were administered iloprost during the study period. Of all the cases, 29.9% were male and the average patient age was 54.45 ± 12.48 years. A comparison of the preoperative, hour 0 and hour 24 baseline parameters showed that pulmonary artery pressure and blood pressure statistically significantly decreased at postoperative hour 24 (p< 0.05). Age, preoperative EF and revisions were found to be statistically significant risk factors for mortality (p< 0.0001). Pulmonary pressures did not affect mortality and were not classified as risk factors. Conclusion: Iloprost treatment might improve postoperative outcomes in patients with high pulmonary arterial pressures and with decreasing pulmonary arterial pressures in the early postoperative period. Treatment with iloprost during the mitral valve replacement decreases high pulmonary arterial pressures and the peroperative mortality risk.