Profile of adult patients presenting for rheumatic mitral valve surgery at a tertiary academic hospital.
Adult
Aged
Echocardiography
/ methods
Female
Heart Valve Diseases
/ diagnostic imaging
Hospitals
Humans
Male
Middle Aged
Mitral Valve
/ diagnostic imaging
Mitral Valve Insufficiency
/ diagnostic imaging
Mitral Valve Stenosis
/ diagnostic imaging
Retrospective Studies
South Africa
Stroke Volume
Ventricular Function, Left
clinical profile
mitral valve
rheumatic heart disease
stratification
Journal
Cardiovascular journal of Africa
ISSN: 1680-0745
Titre abrégé: Cardiovasc J Afr
Pays: South Africa
ID NLM: 101313864
Informations de publication
Date de publication:
Historique:
received:
30
08
2019
accepted:
25
05
2021
pubmed:
23
7
2021
medline:
15
1
2022
entrez:
22
7
2021
Statut:
ppublish
Résumé
Peri-operative morbidity and mortality are increased in patients with rheumatic heart disease. Pre-operative risk stratification is imperative for optimisation and a better outcome. This was a descriptive, retrospective, contextual study. A consecutive convenience sampling method was used. Eighty-nine patients who underwent mitral valve surgery at Charlotte Maxeke Johannesburg Academic Hospital between January 2014 and December 2015 were enrolled. The objectives of the study were to describe the demographic profile of the patients presenting for rheumatic mitral valve surgery, describe their peri-operative cardiovascular and echocardiographic parameters, and risk stratify according to their clinical and echocardiographic parameters. Demographic, echocardiographic and laboratory data as well as the cardiovascular examination were analysed. Descriptive statistics using proportions (percentages), means (standard deviations) or medians (interquartile ranges) were used where appropriate. A total of 102 patients were reviewed. Thirteen were excluded due to significant missing data. Of the 89 analysed, all had demographic data, 81 had cardiovascular clinical examination data, 82 had echocardiographic data and 52 had laboratory data. Forty-seven patients presented with mitral regurgitation (MR) and 35 had mitral stenosis (MS). Data included two mixed mitral valve disease patients with predominant regurgitation who were classified under the MR group. In total, 45% (39 patients) had arrhythmias and 49% (42 patients) had congestive cardiac failure at presentation for surgery. The overall mean (SD) pulmonary artery systolic pressure was 57 (20) mmHg and mean (SD) left atrial size was 53 (11) mm. Those with MS presented with mean (SD) mitral valve area of 0.9 (0.2) cm The majority of those who could be stratified presented in stages C and D of disease progression; however, they also presented with concomitant clinical and echocardiographic features that placed them at high risk of perioperative morbidity.
Sections du résumé
BACKGROUND
Peri-operative morbidity and mortality are increased in patients with rheumatic heart disease. Pre-operative risk stratification is imperative for optimisation and a better outcome.
METHODS
This was a descriptive, retrospective, contextual study. A consecutive convenience sampling method was used. Eighty-nine patients who underwent mitral valve surgery at Charlotte Maxeke Johannesburg Academic Hospital between January 2014 and December 2015 were enrolled. The objectives of the study were to describe the demographic profile of the patients presenting for rheumatic mitral valve surgery, describe their peri-operative cardiovascular and echocardiographic parameters, and risk stratify according to their clinical and echocardiographic parameters. Demographic, echocardiographic and laboratory data as well as the cardiovascular examination were analysed. Descriptive statistics using proportions (percentages), means (standard deviations) or medians (interquartile ranges) were used where appropriate.
RESULTS
A total of 102 patients were reviewed. Thirteen were excluded due to significant missing data. Of the 89 analysed, all had demographic data, 81 had cardiovascular clinical examination data, 82 had echocardiographic data and 52 had laboratory data. Forty-seven patients presented with mitral regurgitation (MR) and 35 had mitral stenosis (MS). Data included two mixed mitral valve disease patients with predominant regurgitation who were classified under the MR group. In total, 45% (39 patients) had arrhythmias and 49% (42 patients) had congestive cardiac failure at presentation for surgery. The overall mean (SD) pulmonary artery systolic pressure was 57 (20) mmHg and mean (SD) left atrial size was 53 (11) mm. Those with MS presented with mean (SD) mitral valve area of 0.9 (0.2) cm
CONCLUSIONS
The majority of those who could be stratified presented in stages C and D of disease progression; however, they also presented with concomitant clinical and echocardiographic features that placed them at high risk of perioperative morbidity.
Identifiants
pubmed: 34292292
doi: 10.5830/CVJA-2021-024
pmc: PMC8756030
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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