Effect Of Different Cardiac Function Before Operation On Early Curative Effect Of Aortic Valve Replacement

Objective:To observe the perioperative data and clinical situation of aortic valve replacement in patients with aortic valve diseases with different cardiac function states,and to explore the influence of different preoperative cardiac function states on the early postoperative treatment effect of patients.Methods:A total of 102patients(67 males and 35 females)who underwent mechanical aortic valve replacement because of aortic valve disease in the first Hospital of Shanxi Medical University from 2013 to 2021 were selected.According to the cardiac function status of the patients,the NYHA cardiac function classification was used as the evaluation criterion.According to the individual cardiac function classification,the patients were divided into three groups: II,III and IV.The main end point of the study was the influence of preoperative different cardiac function on the postoperative curative effect and the probability of complications,and the secondary end point was the comparative analysis of the preoperative basic data and intraoperative related conditions of the three groups of patients.Results:There was no significant difference in aortic cross-clamping time and cardiopulmonary bypass time between IV group and II group during operation,but there was significant difference in ventilator assist time and ICU time between IV group and II group and III group.Comparison of complications: there were 15 cases(14.7%)of postoperative complications in this study,2 cases(4.3%)in cardiac function II group(47 cases),7 cases(18.4%)in cardiac function III group(38 cases),and 6 cases(35.3%)in IV group(17 cases).Univariate and multivariate Logistic regression analysis showed that the probability of postoperative complications in patients with preoperative cardiac function grade IV was 8.454 times higher than that in patients with preoperative cardiac function grade II.Conclusion:Patients with preoperative cardiac function IV have a higher risk of perioperative complications,which is an independent risk factor for postoperative complications.Postoperative recovery is slow,so it is necessary to increase preoperative treatment time,restore cardiac function and reduce perioperative risk.Patients with aortic valve disease should be admitted to hospital to improve the relevant auxiliary examination and actively prepare for operation if they have clinical symptoms.For patients with poor cardiac function(grade III and IV),it is recommended to patiently give conservative treatment before surgery,avoid excessive aortic occlusion time during surgery,shorten the time of cardiopulmonary bypass,and appropriately prolong the patient’s stay in ICU after surgery.