Prognostic factors influencing prolonged ventilation after open mitral valve surgery

Supomo Supomo

doi:10.25077/mka.v43.i1.p1-7.2020

Abstract

Objective: To determine prognostic factors influencing prolonged ventilation after surgery in our hospital. Method: Seventy-five patients fulfilled inclusion criteria were included in this retrospective cross-sectional study. Prognostic factors analyzed were age, chronic pulmonary disease, heart failure (NYHA class function), left ventricular (LV) dysfunction (based on ejection fraction), recent myocardial infarction, pulmonary hypertension (PH), duration of cardiopulmonary bypass (CPB), ischemic time and aorta clamp time, which were analyzed in relation to prolonged ventilation after open mitral valve surgery. Results: Subjects were 75 patients aged between 19 and 62 years old (mean 39.76, SD 11.44) whom underwent open mitral valve repair or replacement surgery. Twenty-three patients (30.67%) had prolonged ventilation (≥24 hours) after surgery. Bivariate analysis showed there were no significant correlation between age, heart failure, PH and LV dysfunction. There are different with statistically significance between groups (p<0.05). Conclusions: In this study, almost one-third of patients had prolonged ventilation after surgery. Factors influencing this morbidity were the duration of ischemic time, aorta clamp time and CPB. Age, heart failure, LV dysfunction and PH were not statistically related to the prolonged ventilation event.

Highlights

The global epidemiology of valvular heart disease has changed dramatically recently
The identification of factors and the calculation of risks to the level of morbidity in cardiac surgery patients is very useful, there has never been any research on prognostic factors that affect prolonged ventilation after mitral valve surgery at Dr Sardjito General
Preoperative factors consist of age, chronic lung disease, heart failure, left ventricular dysfunction, recent MI and pulmonary hypertension while intraoperative factors were the duration of cardiopulmonary bypass (CPB), ischemic time and aortic clamp time

Summary

Introduction

The global epidemiology of valvular heart disease has changed dramatically recently. Rheumatic heart disease (RHD) which was the main cause of valvular heart disease prior to World War II, has reduced its incidence, due to the development of new antibiotics and improvement of healthcare system, especially in developing countries. The identification of factors and the calculation of risks to the level of morbidity in cardiac surgery patients is very useful, there has never been any research on prognostic factors that affect prolonged ventilation after mitral valve surgery at Dr Sardjito General

Results

Conclusion