Analysis of early death after cardiac valve replacement surgery

    CHEN Lin, XIAO Yingª²Bin, WANG Xueª²Feng, ZHONG Qianª²Jin, CHEN Baiª²Cheng, CHEN Jinª²Jin

    Department of Cardiovascular Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China

    ¡¾Abstract¡¿ AIM: To define the risk factors for early death after cardiac valve replacement surgery in 1092 patients. METHODS: Clinical data of patients after cardiac valve replacement were analyzed retrospectively, including preª²operative heart function, operative methods, cardiopulmonary bypass and aorta crossª²clamp time, death causes, blood CK and CKª²MB. RESULTS: There were 21 cases (1.93%, 21/1092) of early death, of whom 9 cases (2.03%, 9/444) had cardiac valve replacement with onª²pump on arrestedª²heart by cold blood cardiopledia, and 12 cases (1.85%, 12/648) had cardiac valve replacement with onª²pump on beatingª²heart. There was no significant difference between the 2 groups (P>0.05). The mortality was lower in mitral valve replacement (MVR) group than that in double valve replacement (DVR) group (P<0.05). The cardiopulmonary bypass and aorta crossª²clamp time were prolonged and blood CK and CKª²Mb increased significantly in death cases than those in surviving cases (P<0.01). No significant difference was found in preª²operative FS and EF. The low cardiac output syndrome was the leading cause of early death, and there were 12 patients (57.2%, 12/21) died of the syndrome. The other causes were sudden death, severe ventricular arrhythmia, respiratory failure and multiple organ failure. CONCLUSION: The mortality is relatively high in patients treated with DVR, especially in those cases with longer cardiopulmonary bypass and aorta crossª²clamp time and the higher density of blood CK and CKª²Mb. The low cardiac output syndrome is the leading cause of early death. ......