Mitral regurgitation, perioperative hemodynamic goals

Mitral regurgitation`

 Heart rate/rhythm

  •  Low heart rates are deleterious: 80-100 beats/min (sinus rhythm) ideal range
  •  Patients often present with atrial fibrillation

Preload/contractility

  •  Maintain preload and contractility

Systemic and pulmonary vascular resistance

  • Decrease in left ventricular afterload (decrease in systemic vascular resistance) can reduce the degree of regurgitation through the valve
  • Pulmonary hypertension may occur with chronic mitral regurgitation (often combined with mitral stenosis) and require pharmacological treatment

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