Efficacy of valve replacement surgery in patients with severe pulmonary hypertension.
J Pak Med Assoc
; 61(9): 893-6, 2011 Sep.
Article
em En
| MEDLINE
| ID: mdl-22360031
ABSTRACT
OBJECTIVES:
To evaluate the safety of valve replacement surgery in rheumatic heart disease patients with severe pulmonary hypertension (SPH); defined as pulmonary artery systolic pressure (PASP > or = 60 mmHg) on patients operated for valve replacement at Tabba Heart Institute, Karachi.METHOD:
From July 2005 to September 2007, total of 112 patients underwent valve replacement (AVR, MVR, AVR+MVR) at our institution. We retrospectively examined the patients with SPH.RESULTS:
The malefemale ratio was 816, age range 18 to 70 years. Data was entered in SPSS version 16. Student t test was used for analyzing the qualitative data and chi-square for the quantitative data. Each case was reviewed on its merit and patient safety maintained by the cardiology and anaesthesia team. Twenty four patients had SPH (range; 60 to 120 mmHg, mean 77.38). Fifteen underwent MVR; AVR one and 7 had AVR+MVR and one MVR + CABG. Three bioprosthetic and 21 mechanical prostheses were implanted. LVEF ranged from 47% to 75 %. Left atrium size ranged from 35 mm to 160mm. Out of 24 patients 10 patients had giant left atria (>6.5 cm). Four patients had dilated RV (range; 17mm to 31 mm). We observed no operative mortality, one patient developed post-operative pulmonary hypertensive crisis and one developed acute renal failure. The incidence of post-op atrial fibrillation was 12.5%. All patients were NYHA class IV pre-operatively and NYHA class I or II post-operatively. There were no neurological or pulmonary complications in our series and none of the patients had re-exploration for bleeding.CONCLUSION:
Cardiac surgery can be successfully performed with an acceptable morbidity and very low mortality in patients with long standing valvular disease and SPH.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cardiopatia Reumática
/
Índice de Gravidade de Doença
/
Implante de Prótese de Valva Cardíaca
/
Hipertensão Pulmonar
Tipo de estudo:
Observational_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Pak Med Assoc
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Paquistão