Surgical Experience Of Severe Heart Valve Disease

Objectives:To find the prognostic factors of severe heart valve disease, and make a further improvement of surgical innovation for kinds of severe heart valve disease, meanwhile, reduce the incidence rate of complications and mortality, elevate the success rates of operation, improve the long-term quality of life.Methods:We performed a retrospective analysis of severe heart valve disease in our hospital from January1,2010to December31,2012. A total number of177patients date were obtained (inclusion criteria of severe heart valve disease includes:giant left ventricle, small left ventricle, emergency valvular surgery, repeated valvular surgery, one-stage surgery with coronary artery bypass grafting or great vessels surgery, combined with other organ failure, syndrome of cardiac cachexia). And we compare the date with control group (non-severe heart valve disease at the same period in our hospital) and the date from other heart center.Results:Severe heart valve disease has a significantly higher incidence rate of perioperative complications, and a longer time in the aspects of surgery, aortic blocking, ICU and hospital stay than non-severe heart valve disease.Surgery mortality of severe heart valve disease is4%(7/177). Patients with giant left ventricle has the mortality of7.7%(1/13), small left ventricle has the mortality of0(0/4), emergency valvular surgery has the mortality of0(0/12), repeated valvular surgery has the mortality of4%(1/25), repeated valvular surgery without preoperative other organ failure has the mortality of0(0/25), one-stage surgery with coronary artery bypass grafting or great vessels surgery has the mortality of3.1%(4/130), patients combined with other organ failure has the mortality of9.1%(2/22), and patients with syndrome of cardiac cachexia has the mortality of0(0/3). Valvular disease combined with coronary artery bypass grafting accounts for the highest proportion (44.1%). Postoperative infection is the most common complication of Bentall surgery according to the study, and preoperative renal failure in patients with valvular disease has the highest mortality.Conclusions:Repeated valvular surgery and one-stage valvular surgery with great vessels surgery also belong to severe heart valve disease surgery. Severe heart valve disease has a significantly higher mortality than non-severe heart valve disease, surgeons should pay attention to these risk factors. By strengthening perioperative management, grasping the surgical indication, optimizing surgical process, improving surgical techniques, choosing the appropriate prosthetic valve can significantly improve the success rate of operation and improve patient prognosis.