Fatores de risco para mortalidade hospitalar no implante de prótese valvar mecânica

Abstract

Fatores de risco para mortalidade hospitalar no implante de prótese valvar mecânicaRisk factors for hospital mortality in valve replacement with mechanical prosthesis Rev Bras Cir Cardiovasc 2009; 24(3): 334-340 requiring long time of anticoagulation and for those who wishes to minimize the need for reoperation. The aim of this prospective study, with retrospective data acquisition, is to review the number of patients who underwent implantation of mechanical heart valve prosthesis, St Jude Medical model, in order to identify risk factors that can influence hospital mortality. METHODS Study CharacteristicsProspective study with retrospective data acquisition. PopulationThe study included 335 patients who underwent at least one mechanical prosthesis of St. Jude Medical model, from December 1994 to September 2005, at Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology. Of these, 181 (54%) were male and 154 (46%) were females, aged between 16 and 78 years, mean 46.8 ±

Risk factors for hospital mortality in valve replacement with porcine bioprosthesis at an universitary institution

“…Fornari ACT, et al -Risk factors for hospital mortality in valve replacement with porcine bioprosthesis at an universitary institution definition of hospital risk for mechanical valve prosthesis implantation [15], in which hospital mortality observed was 3.9%, in favor of the present series, 9.9%. It is possible that several demographic characteristics determine the difference in mortality, taking into account the mean age of patients referred for mechanical prostheses implantation and bioprostheses implantation, higher in the latter group (46.8 years and 66.5 years, respectively).…”

“…This attitude is justified by the ready availability of medical information considered as part of the hospital record, and also because they had been previously used by the authors [13][14][15]. We opted to include pulmonary arterial hypertension as an additional factor, but other recognized factors were excluded, such as chronic obstructive pulmonary disease and peripheral vascular disease [3], which were not always correctly referred or quantified in hospital records.…”

“…The porcine bioprostheses are used in approximately 40% of patients who underwent implantation of biological valve replacements, however, the results of these procedures have not been evaluated, unlike what happened with the surgical valve replacement with a bovine pericardial prostheses [13,14] and mechanical prostheses [15], whose analysis has allowed to stratify the implant surgical risk and decrease the operative mortality.…”

Resultados de pacientes submetidos à cirurgia de substituição valvar aórtica usando próteses mecânicas ou biológicas

“…This is because there is no ideal substitute to provide a long life, without the use of oral anticoagulants, with no increased risk of thromboembolism and operating mechanism similar to the native valve [8][9][10][11][12][13][14]. Still, the clinical decision becomes increasingly challenging with the increase in life expectancy and the presence of comorbidities such as advanced age, congestive heart failure, coronary artery disease, pulmonary disease and renal failure [6].…”

Insuficiência renal oculta acarreta risco elevado de mortalidade após cirurgia de revascularização miocárdica

“…Kidney failure is one of the most important risk factors for complications after both acute ischemic cardiac events [1][2][3][4] and in cardiac surgery, causing longer hospital stays and higher in-hospital mortality [5,6]. In coronary artery bypass grafting (CABG), the previous presence of renal dysfunction is an independent predictor of operative mortality [5.7 to 12].…”