Introduction We aimed to identify predictors of morbidity and mortality in patients undergoing isolated mitral valve replacement. Methods This is a retrospective cohort study with 164 patients who underwent isolated mitral valve replacement at a referral hospital for cardiovascular diseases, which were performed from January 2011 to December 2016. Data were obtained from medical records, including preoperative, intraoperative, and postoperative information. Statistical analysis was performed to calculate odds ratio (OR), unpaired Student's t -test, and binary logistic regression. P -values < 0.05 were considered significant. Results A total of 69.5% (n=114) of the patients had a diagnosis of rheumatic disease prior to surgery. Mortality rate was 6.7% (n=11). The most observed complication was the occurrence of postoperative arrhythmias (19.5%). On average, patients remained 5.34 days in the intensive care unit. There was a statistically significant enhanced risk of death among patients with previous diagnosis of endocarditis (OR 5.22, 95% confidence interval [CI] 1,368-19,915; P =0.008), reduced ejection fraction (EF) (< 50%) (OR 9.46, 95% CI 2,61-34,35; P <0.001), and mitral regurgitation (MR) (OR 7.7, 95% CI 1.576-37.545; P =0.004). Patients who died were older than those who survived surgery ( P <0.001) and had lower preoperative serum hemoglobin levels ( P =0.018). Logistic regression showed age and reduced EF at preoperative evaluation as predictors of death. Conclusion Older age, reduced serum hemoglobin levels, preoperative diagnosis of endocarditis, reduced EF, and MR were associated with postoperative mortality. Age and reduced EF were predictors of death.
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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