Análise do período intra e pós-operatório, complicações e mortalidade nas cirurgias de revascularização do miocárdio e de troca valvar

Abstract

AIMS: To analyze risk factors, comorbidities, intraoperative and postoperative period, complications and mortality in coronary artery bypass grafting (CABG) and valve replacement (VR) surgeries.METHODS: A retrospective cross-sectional study, carried out in a general hospital, included patients of both sexes, older than 18 years, submitted to CABG or VR. Data on risk factors, comorbidities, intraoperative and postoperative periods, postoperative complications and mortality were collected from patients' records. For statistical analysis, Student's t-test and Pearson's chi-square test were used to compare the variables of interest between the CABG and VR groups, considering p≤0.05 as significant.RESULTS: Of 210 records analyzed, 129 (61.4%) patients had performed CABG and 81 (38.5%) had performed VR. In the intraoperative variables, the following were observed in CABG and in VR, respectively (in minutes): ejection fraction 60.2±11.9 vs. 66.2±11.2 (p=0.001); extracorporeal circulation time 75.4±25.1 vs. 105.4±121.5 (p<0.001); aortic clamping time 60.7±39.3 vs. 75.7 ± 26.2 (p=0.003); time of surgery 200.1±76.3 vs. 198.3±71.5 (p=0.865); time of mechanical ventilation 629.1±296.4 vs. 574.4±135.6 (p=0.076). In the postoperative period, the length of stay in the coronary intensive care unit was 2.5±1.8 days in the CABG and 2.5±0.8 days in the VR (p=0.779). Ninety-six (75%) of the patients submitted to CABG and 46 (59%) of the patients submitted to VR had spontaneous heart beat recovery (p=0.020). The majority of patients did not present complications, both in CABG (n=105, 81.4%) and in VR (n=59, 72.8%) (p=0.561). Mortality was 2 (1.6%) in CABG and 4 (4.9%) in VR (p=0.274). The total death rate during the hospital stay was 2.9%.CONCLUSIONS: In the analysis of the CABG and VT surgeries there were differences during the intraoperative period, but no significant differences in postoperative complications and in hospital mortality were identified. Descriptive and comparative analysis of these two distinct surgical techniques, involving patients with differences in their clinical characteristics, allowed the knowledge of their peculiarities, which could contribute to the planning of care and cardiac rehabilitation of the patient.