In-hospital mortality factor analysis at early stage after heart valve surgery

doi:10.3969/j.issn.2095-4344.2013.53.008

Abstract

Abstract:

BACKGROUND: Actively strengthening the perioperative management in high-risk patients undergoing heart valve replacement can reduce early mortality after heart valve replacement.
OBJECTIVE: To analyze the early postoperative risk factors for in-hospital mortality in patients with valvular heart diseases, and to improve surgical cure rate.
METHODS: A total of 488 patients with rheumatic valvular heart disease who had received heart valve replacement were retrospectively analyzed. The study was completed until early hospital death after heart valve replacement. Univariate and multivariate logistic regression analysis of postoperative risk factors for early death was performed.
RESULTS AND CONCLUSION: Among 488 cases with heart valve surgery, early postoperative deaths occurred in 27 cases, with the total mortality of 5.5%. The main causes of death were low cardiac output syndrome, malignant arrhythmia, and multi-organ failure. Univariate analysis showed that: Age ≥ 60 years, class Ⅳ heart function, valve surgery combined with concomitant coronary artery bypass grafting over the same period, left ventricular ejection fraction ≤ 50%, left ventricular end-diastolic diameter ≥ 70 mm, cardiopulmonary bypass time ≥ 120 minutes, aortic clamping time ≥ 60 minutes were related to the occurrence of death after heart valve replacement (P < 0.05). Multivariate logistic regression analysis showed that: Age ≥ 60 years, class Ⅳ heart function, valve surgery combined with concomitant coronary artery bypass grafting, cardiopulmonary bypass time ≥ 120 minutes, left ventricular ejection fraction ≤ 50%, left ventricular end-diastolic diameter ≥ 70 mm were independent risk factors for early death after heart valve surgery were independent risk factors for early death. Emphasis on perioperative management, a reasonable grasp of these factors for surgical indications, selection of the appropriate surgical approach and myocardial protection can further reduce surgical complications and mortality in these patients.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: heart valves, heart valve prosthesis, risk factors, coronary artery bypass, off-pump

CLC Number:

R318

Chen Jing-wei, Yan Fei, Huo Qiang, Zhu Tao, Liu Zheng. In-hospital mortality factor analysis at early stage after heart valve surgery[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(53): 9145-9150.

Figures/Tables 4

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