Early complications in patients undergoing mitral valve replacement surgery: An observational study

Abstract

Background: Rheumatic fever(RF) & Rheumatic Heart disease(RHD) present a problem in all parts of the world especially in developing countries. In India RHD accounts for 12%-65% hospital admissions related to cardiovascular disease. It is the most common cause of Mitral valve disease with associated morbidity and mortality. Mitral valve replacement (MVR) is the surgical treatment when conservative approach fails.Mitral stenosis(MS), Mitral regurgitation (MR) or both MS+MR are main indications for MVR. Material and Method: Despite a rise in the rate of success of total valve replacement, the procedure has been associated with complications inherent to prosthesis as well as to any intra cardiac procedure. Majority of authors have defined complications occuring within thirty days in post operative period as early complications. Observations and Results: In this observational study of 85 patients at a rural cardiac surgery center, who underwent MVR for Mitral valve disease with concomittant Maze-III procedure(modified) for the surgical ablation of Atrialfibrillation (AF) if present, the early complications observed were General complications( AF, Post operative excessive bleeding, haemolysis,Neurological-psychiatric-Thromboembolic complications, wound infection,respiratory complications, Renal complications,prolonged inotropic support& Mechanical ventillation, Prolonged hospital stay & early mortality and Prosthesis specific complications of Paravulvular regugitation( PVR), Obstruction to valve by thrombus,valve endocarditis. Conclusion: AF was the most common post operative complication observed in 24.7% patients,Acute delirium(psychosis) was seen in 21.17% patients,prolonged hospital stay(more than 10 days) was observed in 17.7% of patients, prolonged inotropic support was needed in 12.9% patients, pulmonary complications were observed in 10.5% patients. The rate for other isolated complications was less than 10% each. Overall mortality rate was 1.17%. Prosthetic Valve related complicaio.