Fatores de risco em operações valvares: análise de 412 casos

Bueno, Ronaldo Machado; Neto, Vicente Avila; Melo, Ricardo F. A.

doi:10.1590/s0102-76381997000400007

Cited by 7 publications

(10 citation statements)

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“…Na literatura internacional, várias análises univariadas (1,2) e multivariadas (3,4) foram realizadas, identificando fatores de risco para morbidade e mortalidade hospitalar. Poucos trabalhos em nosso meio (5,6) analisaram os fatores de risco nas reoperações valvares, não havendo nenhuma análise multivariada destes fatores, não ficando claro quais os fatores de risco independentes para mortalidade na nossa população.…”

Section: Introductionunclassified

Fatores de risco para mortalidade hospitalar nas reoperações valvares

Brandão¹,

Pomerantzeff²,

Souza³

et al. 2002

Rev Bras Cir Cardiovasc

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OBJETIVO: Identificar fatores de risco para mortalidade hospitalar em reoperações valvares. MÉTODO: Foi realizada análise prospectiva de 194 pacientes submetidos a reoperações valvares no período entre julho de 1995 e junho de 1999. As variáveis estudadas foram: sexo, idade, classe funcional, número e tipo de operações prévias, intervalo entre as operações, caráter da operação, creatinina sérica, fração de ejeção do ventrículo esquerdo, diâmetros diastólico e sistólico do ventrículo esquerdo, pressão sistólica de ventrículo direito, atividade de protrombina, relação do tempo de tromboplastina parcial ativada, contagem de plaquetas, tempo de circulação extracorpórea, tempo de pinçamento aórtico, posição e número de valvas, tipo de procedimento, operações associadas e volume de sangramento intra-operatório. Análise univariada e multivariada foi realizada para determinar os fatores de risco para mortalidade hospitalar. RESULTADOS: A mortalidade hospitalar foi de 8,8% (17 pacientes). A análise univariada identificou as seguintes variáveis associadas a maior mortalidade: classe funcional avançada, fração de ejeção do ventrículo esquerdo baixa, atividade de protrombina baixa, creatinina elevada, tempo de circulação extracorpórea prolongado, tempo de pinçamento aórtico prolongado, procedimentos associados e volume de sangramento intra-operatório elevado. Na análise multivariada foram significativas: classe funcional IV, creatinina > 1,5 mg/dl e tempo de circulação extracorpórea > 120 minutos. CONCLUSÕES: As variáveis classe funcional IV, creatinina > 1,5 mg/dl e tempo de circulação extracorpórea > 120 minutos são fatores de risco independentes para mortalidade hospitalar nas reoperações valvares.
OBJECTIVE: Analyse the risk factors for hospital mortality in valvar reoperations. METHOD: A prospective analysis was performed of 194 patients that underwent valvar reoperations between July 1995 and June 1999. The following variables were analysed: sex, age, functional class, number and type of previous operations, cardiac rhythm, urgency at operation, creatinin level, left ventricular ejection fraction, left ventricular systolic and diastolic diameters, right ventricular systolic pressure, prothrombin activity, activated partial thromboplastin time relation, platelets count, extracorporeal circulation time, aortic cross-clamp time, number and position of valves, type of procedure, associated procedures and intraoperative bleeding volume. Univariate and multivariate statistical analysis was performed to determine the risk factors for hospital mortality. RESULTS: The overall hospital mortality was 8,8% (17 patients). Univariate analysis showed that the following variables were associated with higher mortality rates: advanced New York Heart Association functional class, decreased left ventricular ejection fraction, decreased prothrombin activity, increased creatinine level, longer aortic cross-clamp time, prolonged extracorporeal circulation time, concomitant associated procedures, and higher intraoperative bleeding volume. ...

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Section: Introductionunclassified

Fatores de risco para mortalidade hospitalar nas reoperações valvares

Brandão¹,

Pomerantzeff²,

Souza³

et al. 2002

Rev Bras Cir Cardiovasc

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“…Age, for example, has already been associated with higher mortality in several studies, as well as in ours. 3,10,12,16,22,[28][29][30][31] . However, this is still not a consensus, since others have found no difference between groups, 25,32 or even an inverse relationship.…”

Section: Discussionmentioning

confidence: 99%

Women Undergoing Mitral Valve Replacement: A Retrospective Analysis

Moreira¹,

Barletta²,

Baucia³

2021

International Journal of Cardiovascular Sciences

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Cardiovascular disease (CVD) is the leading cause of death in developed countries 1 and, in Brazil, despite regional differences, CVD kills more than any other cause. 2 CVD is also the leading cause of death among women, and usually occurs 7-10 years later than men. 1 However, the prevalence of this disease increases in the postmenopausal period, possibly due to the decrease in estrogen hormone levels.There are few data in the literature about the assessment of risk factors and treatment of CVDs in women, as compared to men, including in Brazil. This leads to a delay in the institution of appropriate therapies, so that women often receive less aggressive treatments and are less likely than their male counterparts to be managed following recommended guidelines. 3 Mitral valve disease is the most common valvular heart disease. In developing countries, the main cause of mitral valve stenosis is rheumatic fever, and mitral valve replacement is currently one of the most common

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“…The mortality rate recorded in the literature for this type of surgery ranges from 1% to 15%, regardless of the type of the implanted prosthesis [2][3][4][5][6][7][8][9]. This variation is justified by differences in demographic and clinical characteristics of patients considered for surgery, the surgical techniques, the position of the valve implantation, the associated surgical procedures [9,10] and in the postoperative care.…”

Section: Introductionmentioning

confidence: 99%

“…This variation is justified by differences in demographic and clinical characteristics of patients considered for surgery, the surgical techniques, the position of the valve implantation, the associated surgical procedures [9,10] and in the postoperative care. Retrospective studies with large numbers of patients were performed to identify characteristics that may affect the surgery outcome and create models of individual risk stratification for different institutions [2][3][4][5]11]. The importance of these studies lies in the prospect of identifying patients at increased surgical risk by assessing their demographic, clinical and operative characteristics, neutralizing or minimizing the risk factors in order to reduce surgical mortality and morbidity, as well as the cost of care [12].…”

Section: Introductionmentioning

confidence: 99%