916-85 Correction of Mitral and Tricuspid Regurgitation Improves Hemodynamic and Clinical Status in the Patients with Primary Dilated Cardiomyopathy

Patients with primary dilated cardiomyopathy particularly at the terminal stage represent a special clinical problem because of refractoriness to medical treatment. The influence of mitral and tricuspid regurgitation to the hemodynamic parameters is very important. In our institution the correction of mitral and tricuspid insufficiency was performed in 24 patients (5 females and 19 males) with the mean age of 48 years. Reconstruction of the mitral annulus was carried out by the application of Carpentier's ring and by the method of Prof. Radovanovic in 9 and 15 patients, respectively.The analysis of hemodynamic parameters was made in the period prior to the surgical intervention (cardiac catheterization, before ECC) and after the correction (after ECC. 24 and 48 hours from ECC). The results are presented in the table:ParameterCathete.Bef. ECCAfter ECC24 h48 hCO (I/min)3.663.776.796.49580CI (l/min/m2)1.872.023.793.463.10CVP (mmHg)8.338.263.654.564.76PAP (mmH9)38.1731.6020.6022.6025.00PCW (mmHg)25.0821.0011.1011.7013.10PVR (dyn.sec.cm-5)605.29461212257291SVR (dyn.sec.cm-5)32853552177116941897Postoperative mortality (30 days) was 0.0%. According to our results, significant hemodynamic and clinical improvement in patients with severe heart failure was attained by the correction of mitral and tricuspid insufficiency. It may serve as a bridge to heart transplantation. Early correction of mitrotricuspid regurgitation slows down progression of myocardial insufficiency