Nutritional assessment after cardiac surgery in patients of severe valvular heart disease with malnutrition.

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]

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

Ukrainian Journal of Cardiology ◽

10.31928/1608-635x-2019.2.5762 ◽

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.

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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

Nepalese Heart Journal ◽

10.3126/njh.v15i2.21472 ◽

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.

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Valvular Heart Disease/Cardiac Surgery

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2005.05.003 ◽

2005 ◽

Vol 45 (11) ◽

pp. B20-B23

Author(s):

Shahbudin H. Rahimtoola

Keyword(s):

Cardiac Surgery ◽

Heart Disease ◽

Valvular Heart Disease

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Acetylcholine reactivity in the pulmonary artery during cardiac surgery in patients with ischemic or valvular heart disease

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1016/s1053-0770(97)90055-0 ◽

1997 ◽

Vol 11 (4) ◽

pp. 458-462 ◽

Cited By ~ 7

Author(s):

Monika Angdin ◽

Göran Settergren

Keyword(s):

Cardiac Surgery ◽

Heart Disease ◽

Pulmonary Artery ◽

Valvular Heart Disease

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Comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting or correction of valvular heart disease

Journal of Cardiovascular and Thoracic Research ◽

10.15171/jcvtr.2018.05 ◽

2018 ◽

Vol 10 (1) ◽

pp. 28-35 ◽

Cited By ~ 1

Author(s):

Vladimir A Shvartz ◽

Anton R Kiselev ◽

Anatoly S Karavaev ◽

Kristina A Vulf ◽

Ekaterina I Borovkova ◽

...

Keyword(s):

Cardiac Surgery ◽

Heart Disease ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Comparative Study ◽

Valvular Heart Disease ◽

Artery Bypass ◽

Bypass Grafting ◽

Short Term ◽

Cardiovascular Autonomic Control

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

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.741377 ◽

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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