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