Various clinical factors’ influence on long-term results of valve prosthetic surgery in heart valve disease
Abstract
Aim. To assess factors influencing the long-term results of valve prosthetic surgery in heart valve disease.
Material and methods. In total, 310 patients with heart valve surgery in anamnesis were examined: 168 females (54%), 142 males (46%); mean age 54.2±1.6 years. The most frequent cause of heart valve pathology was rheumatism (n=248; 80%); infectious endocarditis (n=49; 16%) and primary valvular degeneration (n=13; 14%) were less common. Patients’ status was assessed by NYHA classification and the Duke Activity Status Index; their quality of life (QoL) – by general methods (Medical Outcomes Study, 36-Item Short Health Survey, Nottingham Health Profile) and disease-specific instruments (Minnesota Living with Heart Failure Questionnaire, Kansas City Cardiomyopathy Questionnaire). To assess the association between individual parameters, Pearson linear correlation analysis was used.
Results. Most participants underwent mitral valve prosthetic surgery, with mechanical prosthesis implantation. Comparing to biological prosthesis implantation, the rates of re-operation, thromboembolia, prosthetic infectious endocarditis, paravalvular fistules were higher. The factors associated with long-term adverse outcomes were: prosthetic infectious endocarditis, mechanic prosthesis implantation, and left atrium thrombosis in post-surgery period. Moreover, these factors negatively affected subjective QoL parameters.
Conclusion. Correlation analysis can be used for assessing long-term results of heart valve prosthetic surgery.
About the Authors
L. I. Murzabekova
Russian Medical Academy of Postgraduate Education, Moscow
Russian Federation
Russian Federation
V. A. Orlov
Russian Medical Academy of Postgraduate Education, Moscow
Russian Federation
Russian Federation
References
1. Gams E, Hagl S, Schad H, et al. Significance of the subvalvular apparatus for left-ventricular dimensions and systolic function: experimental replacement of the mitral valve Thorac Cardiovasc Surg 1991; 39: 5-12.
2. Hlatky MA, Boineau RE, Higginbotham MB, et al. A Brief SelfAdministrated Questionnaire to Determine Functional Capacity (The Duke Activity Status Index) Am J Cardiol 1989; 64: 651-4.
3. Liang M, Shadick N. Feasibility and Utility of Adding DiseaseSpecific Outcome Measures to a Database to Improve Disease Management. Ann Intern Med 1997; 127: 739-42.
4. Thompson DR, Meadows KA, Lewin RJP. Measuring quality of life in patients with coronary heart disease. Eur Heart J 1998; 19: 693-5.
5. Green CP, Porter CB, Bresnahan DR, Spertus JA. Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure. JACC 2000; 35(5): 1245-55.
6. Либис Р.А., Коц Я.И., Агеев Ф.Т., Мареев В.Ю. Качество жизни как критерии успешной терапии больных с хронической сердечной недостаточностью. РМЖ 2000; 2: 3-8.
7. Green CP, Porter CB, Bresnahan DR, et al. The Kansas City cardiomyopathy questionnaire, a new quality of life measure for heart failure is reliable and responsive to clinical change [abstr]. JACC 1999; 33(2 Suppl A): 247A.
8. Reddy P, Dunn AB. The Effect of Beta-Blockers on Health-Related Quality of Life in Patients with Heart Failure. Pharmacotherapy 2000; 20(6): 679-89.
9. Le Tourneau Т, de Groote P, Millaire A, et al. Persistent elevation of atrial natriuretic peptide level six months after correction of mitral regurgitation. J Heart Fail 1996; 13: 51-6.
10. Марцинкявичус A.M., Палющинская Н.А., Латвенене Л.И. и др. Причины снижения стабильности хороших результатов выживаемости и частота осложнений у больных с многоклапанным протезированием сердца. Кардиология 1988; 28(9): 17-21.
11. Cobbe SM. Incidence and risks associated with atrial fibrillation. PACE 1994; l7: l005-10.
12. Амосов Н.М., Бендет Я.А., Кнышов Г.В. и др. Отдаленные исходы и вопросы реабилитации больных после протезирования клапанов сердца при ревматических пороках. Воп. ревмат. 1982; 2: 9-14.
13. Петрунина Л.В. Физическая реабилитация больных после протезирования митрального или аортального клапана. Кардиология 2000; 20(6): 51-3.
14. Кулешова Р.Г., Щукин B.C., Илюхина Л.Б. и др. Принципы ведения больных, прооперированных по поводу приобретенных пороков сердца. Новосибирск 1991; 32-4.
Review
For citations:
Murzabekova L.I., Orlov V.A. Various clinical factors’ influence on long-term results of valve prosthetic surgery in heart valve disease. Cardiovascular Therapy and Prevention. 2005;4(1):72-77. (In Russ.)
Views:
435
Email this article 
