Analysis Of Risk Factors Before Cardiac Valve Replacement Of Rheumatic Heart Disease

Objective To examine preoperative risk factors associated with death after cardiac valve replacement within 30 days and discuss its possible preventive methods for better patient selection and decreasing risk. Methods From January 1996 to December 2004 ,460 patients who had undergone cardiac valve replacement procedure were reviewed and divided into two groups according to whether death appeared after operation within 30 days .Death group including 50 cases who died after operation within 30 days,control group including 60 cases taken from 410 cases by random who had no death occured on.The clinical dates, indexes of ultrasonocardiography(UCG),kinds of valvular disease and methods of operation ,preoperative complications and other organs, and tissues, complicating disease ,were selected and the risk factors of death were analysed with Logistic regression method. Results Preoperative left ventricular end-diastolic diameters (men>75mm,women>70mm), left ventricular post-wall>10mm, history of disease≥15 years,preoperative New York Heart Association class(NYHA),kinds of cardiac valve disease,degree of complex of cardiac valve replacement, preoperative change of ST-T and coronary artery disease were independent predictors of postoperative death within 30 days. Conclusion Early mortality rates were higher than other periods after cardiac valve replacement. Preoperative New York Heart Association class(NYHA),left ventricular dimension, history of disease, kinds of cardiac valve disease,degree of complex of cardiac valve replacement,coronary artery disease affect early mortality rates after operation.Preoperative definitive diagnosis, effective treatment and operating below the dates of risk factors are necessary. More cases review and clinical trials are necessary for further evaluating the early and late results of cardiac valve replacement.