Effect of the operative timing on patients with rheumatic mitral stenosis during the perioperative period

Abstract

Objective To investigate the effect of operation timing on patients with rheumatic mitral stenosis underwent valve replacement during perioperative period. Methods Retrospective analysis were performed on 122 cases diagnosed as rheumatic mitral stenosis (mitral stenosis, MS) underwent valve replacement, during January 2012 through December 2013 in the Department of Cardiovascular Surgery, General Hospital of Shenyang military region. According to the mitral valve area (mitral valve area, MVA) measured by echocardiography before operation, patients were respectively divided into three groups, mild stenosis (>1.5 cm2), moderate stenosis (1.0~1.5 cm2), and severe stenosis (<1.0 cm2). Through the single factor and multi-factor logistic regression analysis on all clinical data collected from patients, the effects of operation timing on patients were confirmed in perioperative period in each group. Results The results were satisfied in the group. Heart function was significantly raised compared to that before surgery, and the life quality of the patients was improved. Two cases died during hospitalization, New York Heart Association Functional Class (NYHA) reached between Ⅰ~Ⅱ, Ⅱ, perhaps I for survival. Single factor analysis showed that the pulmonary arterial systolic pressure (pulmonary arterial systolic pressure, PASP), left ventricular end diastolic volume, mitral valve area, cardiothoracic ratio, intensive care unit (ICU) staying, ventilator-assistant during hospitalization were influence factors on surgical opportunity of patients with rheumatic mitral stenosis and perioperative outcomes. Multivariate logistic regression analysis showed that pulmonary artery pressure and mitral valve orifice area were the independent influence factors on surgical timing by collecting perioperative outcomes in the groups. Conclusions Mitral valve replacement (mitral valve replacement, MVR) is an effective method in the treatment of rheumatic mitral stenosis. Timely operation can improve the prognosis of patients in the perioperative period, and help to improve the quality of life. Early treatment should be an important factor affecting the perioperative prognosis. Timely operation, early treatment may improve the patient's survival during perioperative period. Key words: Mitral valve stenosis/SU; Rheumatic heart disease/SU; Heart valve prosthesis implantation; Intraoperative period