Valvular Heart Disease

2015 ◽  
pp. 168-215
Author(s):  
Christine M. Lennon ◽  
Alexander C. P. Fort ◽  
Shawn Hansberry
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Severe Disease ◽  
Preoperative Assessment ◽  
Cardiovascular Disorder ◽  
The United States ◽  
Multimodal Approach ◽  
Number Of Patients ◽  
Diagnostic Capabilities

Valvular heart disease is a common cardiovascular disorder, with an estimated prevalence of 2.5% in the United States. The disease is particularly burdensome in adults over 75 years of age, with 13.3% having moderate to severe disease of the aortic or mitral valve. As populations grow older, diagnostic capabilities improve, and health care becomes more accessible, the number of patients with valvular heart disease undergoing both cardiac and non-cardiac surgery will continue to grow. The preoperative assessment and optimization of these patients is a complex task involving multiple specialists, including internists, cardiologists, intensivists, cardiothoracic surgeons, and anesthesiologists. As newer therapeutic options are offered to patients with numerous comorbidities, the preoperative management of these patients will require a sophisticated multimodal approach. The purpose of this chapter is to summarize the preoperative assessment and optimization of patients with valvular heart disease undergoing cardiac and non-cardiac surgery.

scholarly journals Successful Triple Valve Surgery in an Undernourished Patient: What to Prepare?

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Dian Paramita Kartikasari ◽  
Esti Hindariati
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Procedures ◽  
Valvular Heart Disease ◽  
Nutritional Assessment ◽  
Cardiac Surgical Procedures ◽  
The United States ◽  
Organ Injury ◽  
Individual Risk ◽  
Operative Outcomes

ABSTRACT  Valvular heart disease accountsfor 10% to 20% of all cardiac surgical procedures in the United States. The decision to intervene, as well as the type of intervention for a patient with severe valvular heart disease, should be based on an individual risk-benefit analysis. Once a patient is considered a candidate for cardiac surgery, a comprehensive patient evaluation of medical conditions and comorbidities helps improve operative outcomes and minimize the mortality rate. Patients with severe valvular heart disease with chronic heart failure at times, progressing to malnutrition. Patients undergoing cardiac surgery experience a systemic inflammatory response, which contributes to acute organ injury leading to a higher incidence of comorbidities and worse malnutrition. Therefore, preoperative risk and nutritional assessment are critical in performing safe cardiac surgical procedures. We report a case of a malnourished 17-year-old man with multiple valvular heart disease with optimal preparation, including good nutritional status leading to good outcome of complex cardiac surgery even in the high risk patients. Keywords             : valvular heart disease, malnutrition, perioperative assessmentCorrespondence   : [email protected]

scholarly journals Heart failure requiring hospitalization in patients after cardiac surgery for valvular heart disease

2019 ◽  
Vol 26 (2) ◽  
pp. 57-62
Author(s):  
A. V. Zhadan
Keyword(s):  
Heart Failure ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Reverse Remodeling ◽  
Damage Indicators ◽  
Heart Pathology ◽  
Permanent Form

The aim – to determine the factors associated with the frequency of hospitalizations for decompensation of heart failure (HF) after cardiac surgery in patients with valvular heart disease. Materials and methods. 235 patients who underwent cardiac surgery for valvular heart disease were examined. During the period from 2014 to 2017, a part of patients (129 people) had no hospitalizations, while 106 people were on inpatient treatment from 1 to 10 times, on average 2.78±1.95. The complex of examination of patients along with physical examination included electrocardiography, echocardiography. Results and discussion. During dynamic observation for 2 years in the group of patients without hospitalization, a progressive statistically significant decrease in the size of the left atrium (LA) and left ventricle (LV) as well as an increase in LV contractility were noted, while in the group of patients after hospitalization such changes were not observed. The dimensions of the chambers of the heart remained practically unchanged for 2 years. Thus, it can be concluded that the more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers. Predictors of hospitalizations for HF are the presence of diabetes mellitus, hypertension and permanent form of atrial fibrillation. Conclusions. The probability of progression of heart failure in patients after cardiosurgical intervention for valvular heart pathology is not affected by sex, age, type of lesion of the valve, etiology of valve damage, indicators of echocardiography. Predictors of hospitalizations for heart faiure in the long-term postoperative period are the presence of diabetes, AF, and AH. The more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers.

Introduction and epidemiology

ESC CardioMed ◽  
2018 ◽  
pp. 2637-2639
Author(s):  
Hans Erik Bøtker
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Procedure ◽  
Congenital Heart ◽  
Perioperative Complications ◽  
Left Ventricular ◽  
Medical Attention ◽  
Cardiac Complications ◽  
Postoperative Risk ◽  
Number Of Patients

Perioperative complications during non-cardiac surgery depend on the condition of the patient prior to surgery, the prevalence of co-morbidities, and the magnitude, duration, and timing of the surgical procedure. Cardiac complications most frequently arise in patients with documented or asymptomatic ischaemic heart disease, left ventricular dysfunction, valvular heart disease, and arrhythmias, including the presence of a pacemaker or implantable cardioverter defibrillator, when they undergo surgical procedures that are associated with prolonged haemodynamic and cardiac stress. The increasing ageing of the population has a major impact on perioperative patient management. The number of elderly patients with co-morbidities undergoing surgery increases and new surgical and anaesthesia techniques allow surgeons to operate on patients who were previously declined. In addition, the life expectancy of children with congenital heart disease has improved. Hence, this population increasingly seeks medical attention for other illnesses, adding a rising number of patients who will undergo non-cardiac surgeries. Reduction of peri- and postoperative risk in relation to non-cardiac surgery requires a practical, stepwise evaluation of the patient that integrates clinical risk factors and test results with the estimated stress of the planned surgical procedure.

scholarly journals Prevalence and patterns of coronary artery disease in patients undergoing cardiac surgery for rheumatic and non- rheumatic valvular heart disease in a tertiary care center of Nepal

2018 ◽  
Vol 15 (2) ◽  
pp. 21-24
Author(s):  
Ravi Sahi ◽  
Arun Sayami ◽  
Ratna Mani Gajurel ◽  
Chandra Mani Poudel ◽  
Hemant Shrestha ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Coronary Artery ◽  
Valvular Heart Disease ◽  
Tertiary Care ◽  
Vessel Disease ◽  
Cardiovascular Morbidity And Mortality ◽  
Valvular Heart Diseases ◽  
Artery Disease

Background and Aims: Coronary artery disease (CAD) constitute a major cause of cardiovascular morbidity and mortality worldwide with an enormous burden on healthcare resources. Prevalence and pattern of CAD in patients of rheumatic and non-rhemuatic valvular heart diseases varies widely with limited data on optimal strategies for diagnosis and treatment.Methods: This study includes 97 patients with rheumatic and non-rheumatic valvular heart disease who underwent coronary angiogram (CAG) before cardiac surgery. Patients were divided into two groups based on rheumatic heart disease (RHD) & non-rheumatic disease (Non-RHD) and correlate the patterns of CAD.Results: Out of 97 patients, 22 (22.6%) patients were found to have significant CAD. In patients with non-rheumatic origin CAD was common (15 patients, 68.1%) as compared to rheumatic origin (7 patients, 31. 8%). In rheumatic origin, the prevalence was 7(12.2%) out of 57 patients while in non-rheumatic origin, was 15(37.5%) out of 40 patients. In RHD group, all patients with CAD were found to have single vessel diease (SVD) while, in non-RHD group, 11 patients (73.3%) had SVD, 3 patients (16.7%) had double vessel disease (DVD) and one patient (5.6%) had triple vessel disease (TVD).Conclusions: Prevalence of CAD is higher in patients with non-RHD in comparison to those with RHD. We also found SVD to be the most common pattern of CAD in both rheumatic and non-rheumatic valvular heart disease.

scholarly journals Prediction of Recurrent Atrial Tachyarrhythmia After Receiving Atrial Flutter Ablation in Patients With Prior Cardiac Surgery for Valvular Heart Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Ching-Yao Chou ◽  
Fa-Po Chung ◽  
Hung-Yu Chang ◽  
Yenn-Jiang Lin ◽  
Li-Wei Lo ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Atrial Flutter ◽  
Recurrence Rate ◽  
Valvular Heart Disease ◽  
Conduction Delay ◽  
Study Cohort ◽  
Atrial Tachyarrhythmia ◽  
Significant Difference

Background: Surgical scars cause an intra-atrial conduction delay and anatomical obstacles that facilitate the perpetuation of atrial flutter (AFL). This study aimed to investigate the outcome and predictor of recurrent atrial tachyarrhythmia after catheter ablation in patients with prior cardiac surgery for valvular heart disease (VHD) who presented with AFL.Methods: Seventy-two patients with prior cardiac surgery for VHD who underwent AFL ablation were included. The patients were categorized into a typical AFL group (n = 45) and an atypical AFL group (n = 27). The endpoint was the recurrence of atrial tachyarrhythmia during follow-up. A multivariate analysis was performed to determine the predictor of recurrence.Results: No significant difference was found in the recurrence rate of atrial tachyarrhythmia between the two groups. Patients with concomitant atrial fibrillation (AF) had a higher recurrence of typical AFL compared with those without AF (13 vs. 0%, P = 0.012). In subgroup analysis, typical AFL patients with concomitant AF had a higher incidence of recurrent atrial tachyarrhythmia than those without it (53 vs. 14%, P = 0.006). Regarding patients without AF, the typical AFL group had a lower recurrence rate of atrial tachyarrhythmia than the atypical AFL group (14 vs. 40%, P = 0.043). Multivariate analysis showed that chronic kidney disease (CKD) and left atrial diameter (LAD) were independent predictors of recurrence.Conclusions: In our study cohort, concomitant AF was associated with recurrence of atrial tachyarrhythmia. CKD and LAD independently predicted recurrence after AFL ablation in patients who have undergone cardiac surgery for VHD.

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