The Influence Of Different Cardiac Function States On The Effect After Mitral Valve Replacement

Objective:It is difficult to find mitral stenosis in rheumatic heart disease at an early stage due to its hidden onset and long course of disease,thus affecting the early treatment.It often progresses to chronic or even severe valvular heart disease.Clinical observation shows that patients with mitral stenosis have different preoperative cardiac function status and different postoperative recovery effects.In this study,the perioperative effects of MS patients with different cardiac functional states were observed to further investigate the factors influencing the postoperative effects of mitral valve replacement.Methods:A retrospective study was conducted on the clinical data of 146 patients with mitral stenosis receiving mitral valve replacement from October 2014 to October2019.According to the preoperative cardiac function status,all patients were divided into3 groups: 59 cases of group cardiac function II,62 cases of group cardiac function III,25 cases of group cardiac function IV.Record the preoperative general conditions,surgical conditions and postoperative complications of all patients,and evaluate the perioperative effects of MS patients with different cardiac function states through comparison,and evaluate the influencing factors of the effect of mitral valve replacement through univariate analysis and multivariate logistic regression analysis.Results:In addition to the three groups of patients with preoperative general data(left ventricular ejection fraction,left atrial thrombus and history of atrial fibrillation,embolism)outside comparison difference has no statistical significance(p < 0.05),three groups of patients with operation time,extracorporeal circulation time comparison difference has no statistical significance(p < 0.05),but patients in the Intensive Care Unit treatment time significantly longer than group cardiac function IV,group cardiac function IV breathing machine auxiliary time longer than the group cardiac function II and group group cardiac function III,group cardiac function IV in patients with postoperative flow is significantly higher than group cardiac function II and group cardiac function III,The probability of postoperative complications in group cardiac function IV was significantly higher than that in group cardiac function II,and the difference was statistically significant(P <0.05).Multiple logistic regression analysis showed that the probability of postoperative complications in group cardiac function IV was 5.895 times higher than that in group cardiac function II(P =0.019).Conclusion:The worse the cardiac function,the higher the risk of postoperative complications.Therefore,for patients with moderate and above rheumatic mitral stenosis,as soon as the diagnosis is made,intervention should be conducted as soon as possible to closely monitor the cardiac function.For patients with degree II～III of cardiac dysfunction,surgery should be conducted as soon as possible to relieve obstruction,reduce the pressure of the left atrium and prevent the deterioration of cardiac function.