Mortalidade hospitalar na cirurgia de reconstrução da via de saída do ventrículo direito com homeonxerto pulmonar

Abstract

Mortalidade hospitalar na cirurgia de reconstrução da via de saída do ventrículo direito com homeonxerto pulmonarHospital mortality in surgery for right ventricular outflow tract reconstruction using pulmonary homograft Abstract Background: Hospital mortality in surgical reconstruction of the right ventricular outflow tract using pulmonary homograft is variable.Objectives: To identify risk factors associated with hospital mortality and patients' clinical profile.Methods: Study on children who had undergone reconstruction of the right ventricular outflow tract using pulmonary homograft. We analyzed as risk factors the clinical and surgical variables and prosthesis's morphological aspects.Results: Ninety-two patients underwent surgery between 1998 and 2005, presenting mainly pulmonary atresia with ventricular septal defect and tetralogy of Fallot. Forty patients were treated in the first month of life. 38 patients needed Blalock Taussig surgeries due to clinical severity. The median age at surgery for total correction was 22 months, ranging from 1 to 157 months. Pulmonary homograft size ranged from 12 to 26 mm and length of cardiopulmonary bypass was 132 ± 37 minutes. Postoperatively, there were seventeen deaths (18% cases), on average 10.5 ± 7.5 days after surgery. The predominant cause was multiple organ failure. In the univariate analysis between the types of heart disease, they related to age, time of surgery, size of homograft, pulmonary valve Z value, CPB time, maintenance of the integrity of the homograft and pulmonary tree change. There was no statistical difference in hospital mortality between the variables and the type of heart disease.Conclusion: The right-sided obstructive heart diseases require surgical care in the first days of life. The total correction surgery has a mortality risk rate of 18% but there was no association with any variable studied.Descriptors: Heart defects, congenital. Cardiovascular surgical procedures. Transplantation, homologous. Mortality. Resumo

Circulação Extracorpórea

“…Entering the heart chambers was made possible by this discovery in an almost bloodless field and to correct birth [7][8][9][10] or acquired defects [11][12][13][14][15], which restricted the lives of those who had the misfortune to present problems in the blood propulsive organ and in their own lives.…”