Perioperative Fetal Monitoring during Acute Heart Valve Surgery in the 16th Week of Pregnancy: A Case Study with Follow up after Five Years

Objectives: The study sought to examine the prognostic impact of valvular surgery in patients with severe dilated left ventricle(DL) and assess morphological and functional changes of DL in the early period after operation. Methods: From January 2013 to December 2018, at a single center, 126 patients with severe dilated left ventricle (DL group) and 511 patients with 511 patients with normal sized left ventricle (NL group) underwent heart valve surgery. Retrospective review of the procedure and the postoperative clinical course, including echocardiography were analyzed in 6 to 12-month follow up. Results: Compared with NL group, DL group had significantly higher postoperative all-cause mortality (3.2% vs 1.4%) and complication rate, as well as longer duration of mechanical ventilation and vasoactive agents support. In DL group, 4 (3.2%) patients died in the early postoperative stage among which 2 (1.6%) patients died from multiple organ failure (MOF) secondary to severe low-output syndrome, 2 (1.6%) patients died from ventricular fibrillation. The DL group had longer time of mechanical ventilation and vasoactive agents support than NL group postoperatively. In DL group, the progressive regression of end-diastole diameter (LVEDD) was observed during the follow-up; whereas left ventricular ejection function (LVEF) and left ventricular fractional shortening (LVFS) showed a temporary decrease in early postoperative stage and then improved gradually. Conclusion: Heart valve surgery performed in an experienced center, along with sophisticated perioperative management, could bring satisfying early outcomes to patients with severe dilated left ventricle.

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Follow-up of patients after heart valve surgery: Setting up a nurse-led clinic

British Journal of Cardiac Nursing ◽

10.12968/bjca.2008.3.7.30503 ◽

2008 ◽

Vol 3 (7) ◽

pp. 320-323 ◽

Cited By ~ 3

Author(s):

Anna Anscombe ◽

Jane Cadet

Keyword(s):

Heart Valve ◽

Valve Surgery ◽

Heart Valve Surgery

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Early follow-up after open heart valve surgery reduces healthcare costs: a propensity matched study

Open Heart ◽

10.1136/openhrt-2019-001122 ◽

2019 ◽

Vol 6 (2) ◽

pp. e001122 ◽

Cited By ~ 1

Author(s):

Britt Borregaard ◽

Jacob Eifer Møller ◽

Jordi Sanchez Dahl ◽

Lars Peter Schødt Riber ◽

Selina Kikkenborg Berg ◽

...

Keyword(s):

Heart Valve ◽

Healthcare Costs ◽

Intervention Group ◽

Valve Surgery ◽

Control Group ◽

Heart Valve Surgery ◽

Open Heart ◽

The Mean ◽

The Cost

ObjectivesThe objective was to assess differences in healthcare costs within 180 days after discharge from open heart valve surgery in an intervention group receiving early, individualised and intensified follow-up compared with a historical control group.MethodsA cost-minimisation analysis comparing costs from a consecutive prospective cohort compared with a propensity matched cohort. Costs related to the intervention, hospital (outpatient visits and readmissions) and general practitioners (all contacts) were included. Data were obtained from electronic patient records and registry data. A logistic propensity model was used to identify the historical control group. Main results are presented as mean differences and 95% CIs based on bootstrapping.ResultsAfter matching, the analysis included 300 patients from the intervention group and 580 controls. The mean intervention cost was €171 (SD 79) per patient. After 180 days, the mean healthcare costs were €1284 (SD 2567) for the intervention group and €2077 (SD 4773) for the controls. The cost of the intervention group was €793 (p<0.001) less per patient. The cost differences were explained mainly by fewer readmissions, fewer overall emergency visits and fewer contacts to the general practitioner during out-of-hours in the intervention group.ConclusionsThe intervention consisting of early, individualised and intensified follow-up after open heart valve surgery significantly reduced the healthcare costs within 180 days after discharge.

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Outcomes of eight patients after surgical valve replacement for carcinoid heart disease.

10.22541/au.161435589.96849217/v2 ◽

2021 ◽

Author(s):

Dharmesh RAMLUGUN ◽

Michel KINDO ◽

Jean-Philippe MAZZUCOTELLI

Keyword(s):

Heart Disease ◽

Valve Replacement ◽

Heart Valve ◽

Life Support ◽

Extracorporeal Life Support ◽

Valve Surgery ◽

Carcinoid Heart Disease ◽

Heart Valve Surgery ◽

Mechanical Prostheses

Background and aim Carcinoid heart disease is a rare, acquired heart valvular disease affecting mainly the right chambers. Cardiac surgery is the only definite symptom relieving option and has significantly transformed patient short and midterm prognosis. In this study, we aim to retrospectively analyze the postoperative outcomes of patients with carcinoid syndrome after heart valve surgery. Methods Data was retrospectively collected for patients referred to our institution for carcinoid heart disease and operated between 2013 and beginning of 2021. Results 8 patients underwent heart valve replacement with 1 having quadruple valve surgery, 3 patients had both tricuspid and pulmonary valves changed while 4 had only tricuspid valve replacements ; 3 patients had mechanical prostheses. 3 deaths occurred during the follow-up till date with 2 inside the perioperative period. No case of valvular complications was reported. Mean ICU and hospital stay were 9,4 days (range 1-39) and 23,5 days (range 10-52) respectively. 2 patients needed postoperative dialysis, 1 needed re-intubation and no patient required extracorporeal life support. The mean time period from diagnosis to valve surgery was 16,6 months (range 1-60). Follow-up (2-84 months) showed excellent postoperative clinical status with NYHA 1 in all patients. Conclusions Timely heart valve surgery in patients with close multidisciplinary monitoring is associated with good midterm survival rates and low perioperative valvular complications. Patients should be considered for surgery the soonest possible irrespective of the number of valves concerned as functional status improves drastically in most patients.

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Outcomes of eight patients after surgical valve replacement for carcinoid heart disease.

10.22541/au.161435589.96849217/v1 ◽

2021 ◽

Author(s):

Dharmesh RAMLUGUN ◽

Jean-Philippe Mazzucotelli ◽

Michel KINDO

Keyword(s):

Heart Disease ◽

Valve Replacement ◽

Heart Valve ◽

Life Support ◽

Extracorporeal Life Support ◽

Valve Surgery ◽

Carcinoid Heart Disease ◽

Heart Valve Surgery ◽

Mechanical Prostheses

Background and aim Carcinoid heart disease is a rare, acquired heart valvular disease affecting mainly the right chambers. Cardiac surgery is the only definite symptom relieving option and has significantly transformed patient short and midterm prognosis. In this study, we aim to retrospectively analyze the postoperative outcomes of patients with carcinoid syndrome after heart valve surgery. Methods Data was retrospectively collected for patients referred to our institution for carcinoid heart disease and operated between 2013 and beginning of 2021. Results 8 patients underwent heart valve replacement with 1 having quadruple valve surgery, 3 patients had both tricuspid and pulmonary valves changed while 4 had only tricuspid valve replacements ; 3 patients had mechanical prostheses. 3 deaths occurred during the follow-up till date with 2 inside the perioperative period. No case of valvular complications was reported. Mean ICU and hospital stay were 9,4 days (range 1-39) and 23,5 days (range 10-52) respectively. 2 patients needed postoperative dialysis, 1 needed re-intubation and no patient required extracorporeal life support. The mean time period from diagnosis to valve surgery was 16,6 months (range 1-60). Follow-up (2-84 months) showed excellent postoperative clinical status with NYHA 1 in all patients. Conclusions Timely heart valve surgery in patients with close multidisciplinary monitoring is associated with good midterm survival rates and low perioperative valvular complications. Patients should be considered for surgery the soonest possible irrespective of the number of valves concerned as functional status improves drastically in most patients.

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