The Effectiveness of Heart Valve Replacement Surgery in a Non-Referral Regional Hospital: The Analysis of Outcomes after Isolated and Complex Valve Replacement

Background: To comprehensively investigate early and late outcomes for all valve replacement surgery patients in a non-referral regional hospital database and to compare these results with the literature. Methods: This was a retrospective study and made up of patients undergoing heart valve replacement in the cardiovascular department of a non-referral regional hospital between May 2008 and February 2018. Inclusion criteria were aortic, mitral and double valve replacement with or without CABG. Results: 212 patients were included in the study. Of the 212 patients, 65 were aortic valve replacement, 119 were mitral valve replacement, 28 were double valve replacement patients. Mean follow-up of all patients was 3.4 ± 2.9 years. There was no significant difference among the groups regarding hospital mortality. The occurrence of acute renal failure and neurological event was the main factors of morbidity-associated mortality. Concomitant CABG procedure was found to be an independent predictor of early mortality after MVR. In the AVR group, there was no significant difference between AVR with CABG and without CABG regarding the 5-year survival rates; whereas in MVR and DVR group, there was a statistically significant difference between the groups. According to Cox proportional hazards model for determining factors related to late mortality, preoperative chronic renal failure and concomitant CABG were factors independently related to late mortality after MVR. Conclusion: We believe that our study will contribute to the development of the outcomes of heart valve replacement surgery in these centers by supporting other non-heart center clinics in working toward acceptable morality rates for complex valve surgeries.

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Postconditioning the Human Heart with Adenosine in Heart Valve Replacement Surgery

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2006.12.031 ◽

2007 ◽

Vol 83 (6) ◽

pp. 2066-2072 ◽

Cited By ~ 31

Author(s):

Zhen-Xiao Jin ◽

Jing-Jun Zhou ◽

Mei Xin ◽

Dao-Rong Peng ◽

Xi-Ming Wang ◽

...

Keyword(s):

Valve Replacement ◽

Heart Valve ◽

Human Heart ◽

Heart Valve Replacement ◽

Replacement Surgery ◽

Valve Replacement Surgery

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De Ritis ratio as a significant prognostic factor of international normalized ratio ≥4 in the initial 10 days of warfarin therapy

Biomarkers in Medicine ◽

10.2217/bmm-2019-0033 ◽

2019 ◽

Vol 13 (18) ◽

pp. 1599-1607

Author(s):

Yide Cao ◽

Ganyi Chen ◽

Huangshu Li ◽

Yafeng Liu ◽

Zhonghao Tao ◽

...

Keyword(s):

Valve Replacement ◽

Heart Valve ◽

Warfarin Therapy ◽

Anticoagulation Therapy ◽

International Normalized Ratio ◽

Heart Valve Replacement ◽

Significant Prognostic Factor ◽

Replacement Surgery ◽

The Relationship ◽

Valve Replacement Surgery

Aim: To assess the relationship between the De Ritis ratio on admission and warfarin sensitivity in the initial 10 days of anticoagulation therapy. Methods: We retrospectively reviewed data from 906 patients who underwent heart valve replacement surgery. Results: A De Ritis ratio of 1.19 was identified as the optimal cutoff according to the ROC curve. Patients with a high De Ritis ratio achieved an international normalized ratio (INR) ≥4 more easily and earlier than those with a low De Ritis ratio in the initial 10 days of warfarin therapy. Multivariate analysis showed that a high De Ritis ratio was an independent predictor of an INR ≥4 (HR: 2.567; p < 0.001). Conclusion: A De Ritis ratio ≥1.19 on admission was significantly associated with an INR ≥4 in the initial 10 days of warfarin therapy among patients underwent heart valve replacement surgery.

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The Ethics in Repeat Heart Valve Replacement Surgery

Advanced Concepts in Endocarditis ◽

10.5772/intechopen.76844 ◽

2018 ◽

Author(s):

Julie M. Aultman ◽

Emanuela Peshel ◽

Cyril Harfouche ◽

Michael S. Firstenberg

Keyword(s):

Valve Replacement ◽

Heart Valve ◽

Heart Valve Replacement ◽

Replacement Surgery ◽

Valve Replacement Surgery

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Comparison of the myocardial protective effect of sevoflurane versus propofol in patients undergoing heart valve replacement surgery with cardiopulmonary bypass

BMC Anesthesiology ◽

10.1186/s12871-017-0326-2 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 13

Author(s):

Xiao-Lin Yang ◽

Dan Wang ◽

Guo-Yuan Zhang ◽

Xiao-Lan Guo

Keyword(s):

Cardiopulmonary Bypass ◽

Protective Effect ◽

Valve Replacement ◽

Heart Valve ◽

Heart Valve Replacement ◽

Replacement Surgery ◽

Valve Replacement Surgery

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Analysis on the Constituents and Factors Influencing Hospitalization Expense of Heart Valve Replacement Surgery

Chinese Medical Record English Edition ◽

10.3109/23256176.2013.882574 ◽

2013 ◽

Vol 1 (12) ◽

pp. 543-547

Author(s):

Xiuwei Wang ◽

Xiancheng Liu ◽

Dexiang Liu ◽

Bingwei Wang

Keyword(s):

Valve Replacement ◽

Heart Valve ◽

Heart Valve Replacement ◽

Replacement Surgery ◽

Factors Influencing ◽

Valve Replacement Surgery

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Retrospective investigation of anticoagulant complications in long term after mechanical heart valve replacement surgery in Turkey

10.32592/ircmj.2021.23.1.13 ◽

2020 ◽

Keyword(s):

Emergency Department ◽

Valve Replacement ◽

Heart Valve ◽

Mechanical Heart Valve ◽

Heart Valve Replacement ◽

Factors Affecting ◽

Replacement Surgery ◽

The Mean ◽

Valve Replacement Surgery

Background: Patients with mechanical heart valve replacement surgery (MHVRS) should be followed up in terms of prosthetic valve-related and open heart surgery complications. This study aimed to determine the anticoagulant complications in long term in patients with MHVRS. Methods: This retrospective and descriptive study was conducted in a university hospital, İzmir, Turkey. The data were collected from July to December 2019. In total, 73 patients referring for regular check-ups to the hospital with intervals not exceeded more than 90 days, and those who had international normalized ratio (INR) measurements for January-April-July-October 2018 were included in this study. Results: The mean age of the patients was obtained at 58.98±12.89 years, and 53.4% (n=39) of the cases were male. Moreover, the mean follow-up period was estimated at 65.98±28.47 months. According to the results, complications developed in 60 patients (82.2%). The first hospitalized unit was the emergency department. The factors affecting the development of complications after MHVRS were evaluated, and a difference was found regarding gender (X2=6.18, P=0.013), comorbidities (X2=25.58, P=0.018), and monthly referral for regular check-ups to the hospital (X2=5.20, P=0.023). There was no relationship between the INR levels and the development of complications. Furthermore, the results of evaluating the factors affecting the number of hospitalizations after MHVRS revealed that monthly referral to hospital for check-ups (t=3.18, P=0.002) and history of previous valve surgery (Z=201.00, P=0.03) affected the number of hospitalizations. Conclusions: It was observed that patients frequently refer to the emergency department and struggled with various complications. Moreover, it was found that the patients had frequent bleeding and refer to the emergency service repeatedly. Accordingly, there is a need for interventional studies to reduce postoperative complications and provide the therapeutic INR level.

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