A RETROSPECTIVE CROSS SECTIONAL OBSERVATIONAL STUDY OF SHORT TERM MORTALITY AMONG DIFFERENT SURGICAL VALVE REPLACEMENTS IN A TERITARY CARE CENTRE

Abstract

Background: The main aim of the study is to investigate the etiology of different valvular pathologies , surgical approaches(minimally invasive vs open sternotomy). within 30 day mortaility among different surgical valve replacement groups Methods: The present study is a retrospective cross sectional observational study with data from august 2016 to December 2021 undertaken in government general hospital Kurnool. The data considered includes the age echo reports, angiographic data, surgery details and post surgery status. The study included total 126 patients undergone surgical valve replacement. The patients who were undergone aortic valve replacement surgery were 10 cases (7.9%), patients who were undergone mitral valve replacement were 79 (62.7%) and double valve replacement were 37 (29.4%) .(figure 1) of these 2 AVR cases and 1 MVR case had undergone cabg with valve replacement
Results: The The mean age of patients was 40.3 ± 12.07 years with maximum age of 68 years and minimum age of 13 years The distribution of male population was male 57 (45.2%) and female population was 69 (54.8%) The persons with congenital heart disease are 6(4.8%) ,chronic rheumatic heart disease are 117 (92.9%), degenerative valvular heart disease are 3 (2.4 %). The mean ejection fraction of the patients were 58.66 ± 6.2 with highest ejection fraction noted was 63 and lowest was 35. Patients with EF in the range of > 40 are 123 (97.6%), < 40 are 3 (2.4%) Out of 126 patients 7(5.5%) patients undergone minimally invasive surgery
and 119(95.5%) patients undergone open surgical approach. Among 126 patients undergone procedure 12 patients died.Of the 12 patients 3 cases(25%) belong to AVR group , 4 cases (33.3%) belong to MVR group and 5 case(41.7%) belong to DVR group. Among 7 patients who underwent minimal invasive surgery non had mortality. The distribution of valve groups are 2 AVR cases and 5 MVR cases . Among age matched minimal access surgery mvr group and open surgical group no significant difference found
Conclusion : The most common etiologies among valve replacement surgeries is chronic rheumatic heart disease.Double valve replacement had higher mortality followed by mitral valve replacement and then the aortic valve replacement.The patients who undergone minimally invasive surgery had no mortality but when compared to age matched and valve replacement match individuals no significant mortality difference found but had less hospital stay