Computer-Based Analysis of Preoperative and Postoperative Prognostic Factors in 100 Patients with Combined Aortic and Mitral Valve Replacement

Abstract

From 1963 to 1971, aortic and mitral valves were replaced in 100 patients; 22 died in hospital. Follow-up in survivors is 100%. Catheterization was performed preoperatively in 99 patients and postoperatively in 85% of survivors. The influence of 19 preoperative potential risk factors on hospital mortality, postoperative symptomatic improvement, and long-term survival (assessed by monthly cohort-adjusted survival tables) was determined. Long-term survival was also assessed by comparing average values of the various risk factors in patients surviving 1, 2, and 3 years with values in patients who died during these intervals. In addition, changes induced by operation were studied 6 months postoperatively and their value in predicting subsequent longevity assessed. Significant ( P < 0.05) findings were: a higher hospital mortality in patients with left atrial pressures ≥30 mm Hg or with fabric-covered valves; less postoperative symptomatic improvement in older patients; lower long-term survival rate in men and in patients with high left atrial, right atrial, pulmonary arterial, or right ventricular end-diastolic pressures. A decrease in radiographic heart size or a New York Heart Association class I or II status 6 months postoperatively was associated with a favorable subsequent prognosis. Postoperative hemodynamic values did not predict subsequent survival.

A study to assess valvular heart disease in a tertiary care hospital: a single centre finding

“…[19][20][21] Melvin found that MR+AR was the most common combination of rheumatic valvular lesions. 22 In a study by Essien I O et al, in Nigeria isolated mitral valve involvement was seen in 65.45% isolated aortic valve involvement in 1.8.% and mitral and aortic valve involvement in 33.3% of patients so it matches with present study. 23 In a study by J.N.…”

Incidence & Pattern of Valvular Heart Disease in Patients attended in Echo Lab at a tertiary care Hospital: A single Centre Study

“…Melvin also found that MR+AR, was the most common combination of rheumatic valvular lesion. 54 TS was rheumatic in our study and was almost exclusively seen in association with MR+AR (1.03%). In the necropsy series of Roberts and Virmani.…”

Rheumatic Heart Disease among Patients with Valvular Heart Disease Admitted to the In-patient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…A study of 100 patients with combined aortic and mitral valve replacement discovered that MR + AR was the most common combination of rheumatic valvular diseases. 30 Only 10 patients were reported to have virtually pure AS and AR in a group of patients with mixed aortic and mitral valve disease. 31 …”