The Right Ventricular Responses to Mild Hypercarbia After Mitral Valve Repair Surgery

Study Overview
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Brief Summary
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The aims of the study is to investigate the right ventricular responses to mild hypercarbia after mitral valve prolapse repair surgery by the measurements obtained on pulmonary arterial catheter and transesophageal echocardiography.

Detailed Description
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The aims of the study is to investigate the right ventricular responses to mild hypercarbia after mitral valve prolapse repair surgery by the measurements obtained on pulmonary arterial catheter and transesophageal echocardiography. Investigators hypothesize that induced mild hypercarbia (PaCO2 7.5 kPa) cause elevated mean pulmonary arterial pressure and pulmonary vascular resistance, and this reflect to the right ventricle, both volume and function. And this right ventricle effect could be noticed by echocardiography.

Official Title
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The Right Ventricular Responses to Mild Hypercarbia After Mitral Valve Repair Surgery - Assessment With Pulmonary Arterial Catheter and Transesophageal Echocardiography Measurements

Conditions
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Heart; Decompensation, Right Ventricle, Echocardiography, Hypercapnia

Intervention / Treatment
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* Procedure: Hypercarbia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: scheduled mitral valve prolapse repair surgery able to give informed consent Exclusion Criteria: preoperative right ventricular dysfunction or pulmonary hypertension significant tricuspid regurgitation congenital heart defect ventricular dyssynchrony or wide QRS-complex on ECG (> 130 ms) prior myocardial infarction (within tree months) or pericardial constriction preoperative left ventricular (LV) dysfunction, i.e. LV ejection fraction under 40 % if the scheduled repair by plastic procedure has been converted to mitral valve replacement

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Hypercarbia<br>Hypercarbia: PaCO2 is elevated from 5 to 7.5 kPa by controlled ventilation. | Procedure: Hypercarbia<br>* PaCO2 is elevated from 5 to 7.5 kPa by controlled ventilation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tricuspid annular plane systolic excursion (TAPSE) | TAPSE will be measured at baseline (PaCO2 5 kPa) and at hypercarbia (PaCO2 7.5 kPa) | Change from baseline TAPSE at hypercarbia (in approximately 30 min) | 
| Mean pulmonary artery pressure (MPAP) | MPAP will be measured at baseline (PaCO2 5 kPa) and at hypercarbia (PaCO2 7.5 kPa) | Change from baseline MPAP at hypercarbia (in approximately 30 min) |