VALVULAR PATIENTS

Abstract

Cost effectiveness in any surgical procedure is a major contributory factor in thecontinuation of medical services in developing countries. Limited data is available in assessingthe factors related with the duration of ICU stay and treatment after valvular replacementsurgeries. Objectives: Our aim was to see the correlation of pre operative Left Atrial size of thepatient and duration of post operative stay in ICU. Study Design: Observational Study. Period:March 2010 to April 2014. Setting: Faisalabad Institute of Cardialogoy, Faisalabad. Method:A total of 550 consecutive patients with valvular lesions were included in the study. Their LeftAtrial size was measured echocardiographically pre-operatively and their stay /course in theICU was monitored. Result: Three categories were identified in regard with the Left Atrial sizeand the ICU stay. If LA size is below 60 cm2, the post operative course & stay in ICU is normaland lasts for about 1-2 days. If LA size is between 60-65 mm2, the post operative course maybe complicated & prolonged by the atrial fibrillation / flutter for which pharmacological cardioversion may be needed and the stay in ICU is prolonged and may last for about 2-3 days. Andif pre-operative LA size is more the 65 mm2 the patient may behave in entirely different way. Hisatrial fibrillation persists in spite of electro cardiovertion or pharmacological cardiovertion andhis stay in ICU may last up to 4-5 days and thus the cost of treatment is raised. Conclusions:LA size can predict the post operative behavior of the patient in ICU and duration of stay andexpected cost of the treatment. Smaller is the size of LA, shorter is the stay in ICU and thuslesser is the post operative cost & vice versa.