Relationship between preoperative variables and early postoperative outcome in patients with mitral valve replacement surgery

Abstract

Introduction: Preoperative variables in mitral valve replacement surgery allow an objective preoperative assessment of each patient.

Objective: To determine the influence of preoperative risk factors on mortality and major complications occurring in mitral valve replacement surgery.

Method: Analytical, longitudinal, prospective follow-up study of 158 patients who underwent surgery for mitral valve disease at the Cardiocentro Ernesto Che Guevara of Villa Clara, from 2007 to 2010. A bivariate study was conducted for each independent variable. Mortality and major complications were the dependent variables.

Results: The mean age was 65.2 years, female patients predominated. Smoking, ventilatory disorders, pulmonary hypertension and atrial fibrillation were the most important risk factors. Most patients underwent surgery electively, in functional class II, with left ventricular ejection fraction greater than 50% and predominance of mitral stenosis. The variables that were associated with the risk of major complications were: heart failure, age over 50 years, emergency surgery, the use of hemoderivatives, atrial fibrillation, ventilatory disorders in spirometry and pulmonary acceleration time. Those related to death were: reduced left ventricular ejection fraction, pulmonary acceleration time, heart failure, the use of hemoderivatives, creatinine > 1.5 mg/dl, cardiomegaly and atrial fibrillation.

Conclusions: The relationship between preoperative variables and postoperative morbidity and mortality behaved indistinctly in each surgical center.

Key words: Surgery, Mitral valve stenosis, Mitral valve insufficiency