Clinical Assessment of Mitral Valvular Diseases Requiring Its Prosthetic Replacement

Abstract

Objectives: The patient’s clinical assessment having mitral valvular diseases requiring its prosthetic
replacement was done in the current study. Methods: The study included 45 selected cases of the mitral
valvular lesion that underwent prosthetic replacement of mitral valve admitted in the cardiothoracic surgery
department at a tertiary care centre. A detailed history of each patient was taken, and subsequent management
and follow up was done. The pre-operative clinical features of the patients were presented in terms of
frequencies. Results: The patient’s peak age group was 31 to 40 years, comprising 42.22%. There was a female
predominance with 28 (62.22%) patients. Dyspnea was the presenting feature in all 45 (100%) patients.
Valvular lesions of the patients were diagnosed with Mitral stenosis, Mitral regurgitation and combined
valvular lesion. In the present study, valvular lesions were predominantly associated with Rheumatic fever’s
history in 24 (53.33%) patients. Calcification was noted either in valve leaflet or annulus in 12 (26.66%)
cases. Calcification was confirmed by pre-operative echocardiography and during the perioperative period.
It is equally noted in mitral stenosis cases and combined valvular lesion. The maximum 33 (73.33%) patients
belonged to the NYHA Class III, followed by Class IV. The associated other valvular lesions mainly were in
7 (15.55%) cases that belonged to mild aortic regurgitation. 36 (80%) cases were diagnosed with left atrial
enlargement followed by right ventricular enlargement for 23 (51,11%) patients. Left atrial hypertrophy
was the most common feature for 39 (86.66%) cases. Conclusion: During the pre-operative period, clinical
assessment is critical to determine the extent of illness and type of valvular diseases. The results of this study
are comparable to other similar published clinical observations.