Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: A Retrospective Analysis

Abstract Background Rheumatic mitral valvular disease is more common than degenerative mitral valve disease. Mitral valve repair is not possible in large number of patients because of rheumatic cicatrized subvalvular mitral valve disease. The prosthetic mitral valve replacement is commonly performed in our center. Objective The aim of the study was to evaluate and assess the short outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair. Patients and Methods This study was done in department of Cardiothoracic surgery, Faculty of Medicine at Ain Shams university, after approval of the local ethical committee from 2015 to 2016.The inclusion criteria includes All gender, All age, Primary Mitral valve replacement for severe Mitral valve disease of Rheumatic origin with or without Tricuspid Valve Repair and Primary Mitral valve replacement for severe Mitral valve disease of Degenerative origin with or without Tricuspid Valve Repair and the exclusion criteria includes concomitant coronary artery bypass graft surgery or other cardiac operations or infective endocarditis and Patients with chronic liver, kidney and parenchymal pulmonary disease. Results This study included one hundred and seventy- seven (177) patients; One hundred and thirty one (131) patients did Mitral Valve Replacement without Tricuspid valve Repair, Fourty six (46) patients did Mitral valve Replacement with Tricuspid valve Repair and the outcome was Mortality (3.9%), Reoperaion (5.08%), Stroke (0. 56%), Re-Intubation (1.13%) and Re-Admission to ICU (1.69%) Conclusion The Reoperation has a direct relation and effect on the Mortality,Prolonged bypass time independently predicts postoperative morbidity and mortality and Prolonged aortic cross-clamp time significantly correlates with major post-operative morbidity and mortality.

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Mitral valve surgery for ischemic papillary muscle rupture: outcomes from the Japan cardiovascular surgery database

General Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-020-01418-y ◽

2020 ◽

Vol 68 (12) ◽

pp. 1439-1446

Author(s):

Tomoyuki Fujita ◽

Hiroyuki Yamamoto ◽

Junjiro Kobayashi ◽

Satsuki Fukushima ◽

Hiroaki Miyata ◽

...

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Papillary Muscle ◽

Cardiovascular Surgery ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Short Term ◽

Papillary Muscle Rupture ◽

Muscle Rupture

Abstract Background Ischemic papillary muscle rupture (PMR) is a catastrophic complication following acute myocardial infarction (AMI). We evaluated early outcomes of PMR by using data from the Japan Cardiovascular Surgery Database, a nationwide Japanese registry. Methods We retrospectively analyzed data from 196 patients diagnosed with PMR following AMI in Japan between January 2014 and December 2017. Risk factors for operative mortality and severe complications following mitral valve surgery were analyzed. Results The 30-day and hospital mortality rates were 20% and 26%, respectively. Chronic hemodialysis, abrupt rupture after AMI, resuscitation before surgery, and preoperative venoarterial extracorporeal membrane oxygenation were associated with mortality. Mitral valve replacement was chosen mainly (90%) for surgical correction of mitral regurgitation in these patients. There was no significant difference in short-term outcomes between mitral valve replacement versus mitral valve repair, despite non-matched characteristics in background between the treatment groups. Concomitant coronary artery bypass grafting had no impact on short-term outcomes. Conclusions Information derived from the nationwide database of patients with AMI-associated PMR show that PMR is a rare condition in the modern era. However, PMR is a severe disease with a mortality rate as high as 26%. The severity of the condition is associated with the risk for poor outcomes.

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An associated tricuspid annuloplasty during mitral valve replacement does not increase surgical risk and in-hospital morbidity and mortality: An observational study

Archives of Cardiovascular Diseases Supplements ◽

10.1016/j.acvdsp.2019.09.098 ◽

2020 ◽

Vol 12 (1) ◽

pp. 46-47

Author(s):

B. Kichou ◽

N. Henine ◽

M. Ait Said ◽

S. Mehlal ◽

S. Brahimi ◽

...

Keyword(s):

Mitral Valve ◽

Observational Study ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Morbidity And Mortality ◽

Surgical Risk ◽

Tricuspid Annuloplasty ◽

Hospital Morbidity

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Risk factors for morbidity and mortality in mitral valve replacement

European Journal of Cardio-Thoracic Surgery ◽

10.1016/1010-7940(90)90072-8 ◽

1990 ◽

Vol 4 (8) ◽

pp. 425-430 ◽

Cited By ~ 5

Author(s):

M ABDELNOOR ◽

N FJELD ◽

K VAAGE ◽

J SVENNEVIG ◽

G KLINGEN ◽

...

Keyword(s):

Risk Factors ◽

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Morbidity And Mortality

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Prosthesis-patient mismatch after mitral valve replacement: a single-centered retrospective analysis in East China

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-018-0788-4 ◽

2018 ◽

Vol 13 (1) ◽

Cited By ~ 4

Author(s):

Armah M Akuffu ◽

Haige Zhao ◽

Junnan Zheng ◽

Yiming Ni

Keyword(s):

Mitral Valve ◽

Retrospective Analysis ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

East China

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Women Undergoing Mitral Valve Replacement: A Retrospective Analysis

International Journal of Cardiovascular Sciences ◽

10.36660/ijcs.20200412 ◽

2021 ◽

Author(s):

Júlia Lasserre Moreira ◽

Pedro Henrique Andrade Araújo Salvatore Barletta ◽

José Augusto Baucia

Keyword(s):

Mitral Valve ◽

Retrospective Analysis ◽

Valve Replacement ◽

Mitral Valve Replacement

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Effects of Controlling of Blood Glucose in Adult Non-Diabetic Patients Undergoing Mitral Valve Replacement

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v10i2.44119 ◽

2019 ◽

Vol 10 (2) ◽

pp. 114-120

Author(s):

Md Armane Wadud ◽

Syed Dawood Md Taimur ◽

Syed Tanvir Ahmed ◽

Shanoor Aziz ◽

Ibrahim Khalilullah ◽

...

Keyword(s):

Blood Glucose ◽

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Postoperative Morbidity ◽

Morbidity And Mortality ◽

Diabetic Patients ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Group B

Background: The objective of this study was to see whether there is an association between high blood glucose levels after operation under CPB and post-operative morbidity and mortality. Methodology: This cohort study was carried out in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Sher-e-Bangla Nagar, Dhaka from January, 2012 to December, 2013 for a period of twenty four (24) months. A total number of 110 patients who underwent MVR operation with CPB were enrolled in this study as per inclusion and exclusion criteria. Patients were divided into two groups according to their blood glucose levels, recorded within first 60 hrs after Mitral Valve Replacement Surgery under Cardiopulmonay Bypass. Patients having blood glucose level of less than 10.1 mmol/L (unexposed) and patients having blood lactate level of 10.1 mmol/L or more (exposed) were grouped. Post operative variables were observed and recorded during the hospital course of the patient. Result: A total number of 110 patients were enrolled in this study. Blood glucose levels lower than or equal to10 mmol/L after MVR were present in 55(50%) patients (Group A) Blood glucose levels higher than 10 mmol/L after MVR were present in 55(50%) patients. Postoperative morbidity was higher in this group (Group B) than in the patients who had peak blood glucose levels of less than or equal to 10 mmol/L MVR (p=0.001). Postoperative ICU stay was prolonged in patients with elevated levels of blood glucose after MVR under CPB compared with of patients with lower blood glucose levels (p=0.001). Other common morbidities are Neurological complication (p=0.04), Renal dysfunction (p=0.01), wound infection (p=0.04), Post-operative hospital stay (p=0.004). also higher in group B patient, as well as mortality (p=0.31). Conclusions: Blood glucose concentration of 10.1 mmol/L or higher after MVR under CPB is an important issues related to postoperative morbidity and mortality Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 114-120

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