Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplas...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Renata Cristina Castro Cruz [verfasserIn] Bruna Silva Cordeiro [verfasserIn] Felipe de Souza Santos [verfasserIn] Caroline Rodrigues Fernandes [verfasserIn] Julia Maria Alves Gama [verfasserIn] Ana Marice Teixeira Ladeia [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch ; Portugiesisch |
| Schlagwörter: |
Insuficiência da Valva Mitral/cirurgia |
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| Übergeordnetes Werk: |
In: Arquivos Brasileiros de Cardiologia - Sociedade Brasileira de Cardiologia (SBC), 2004 |
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| Links: |
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| DOI / URN: |
10.5935/abc.20190184 |
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| Katalog-ID: |
DOAJ072318457 |
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| 520 | |a Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. | ||
| 650 | 4 | |a Cardiopatias Congênitas | |
| 650 | 4 | |a Insuficiência da Valva Mitral/cirurgia | |
| 650 | 4 | |a Hipertensão Pulmonar | |
| 650 | 4 | |a Reoperação | |
| 650 | 4 | |a Insuficiência da Valva Tricúspide/cirurgia | |
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| 700 | 0 | |a Caroline Rodrigues Fernandes |e verfasserin |4 aut | |
| 700 | 0 | |a Julia Maria Alves Gama |e verfasserin |4 aut | |
| 700 | 0 | |a Ana Marice Teixeira Ladeia |e verfasserin |4 aut | |
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10.5935/abc.20190184 doi (DE-627)DOAJ072318457 (DE-599)DOAJ081c38894c4b4436bd0b0b297948d074 DE-627 ger DE-627 rakwb eng por RC666-701 Renata Cristina Castro Cruz verfasserin aut Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. Cardiopatias Congênitas Insuficiência da Valva Mitral/cirurgia Hipertensão Pulmonar Reoperação Insuficiência da Valva Tricúspide/cirurgia Cardiopatia Reumática Diseases of the circulatory (Cardiovascular) system Bruna Silva Cordeiro verfasserin aut Felipe de Souza Santos verfasserin aut Caroline Rodrigues Fernandes verfasserin aut Julia Maria Alves Gama verfasserin aut Ana Marice Teixeira Ladeia verfasserin aut In Arquivos Brasileiros de Cardiologia Sociedade Brasileira de Cardiologia (SBC), 2004 (DE-627)320623572 (DE-600)2023015-1 16784170 nnns https://doi.org/10.5935/abc.20190184 kostenfrei https://doaj.org/article/081c38894c4b4436bd0b0b297948d074 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005017102&lng=en&tlng=en kostenfrei https://doaj.org/toc/1678-4170 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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10.5935/abc.20190184 doi (DE-627)DOAJ072318457 (DE-599)DOAJ081c38894c4b4436bd0b0b297948d074 DE-627 ger DE-627 rakwb eng por RC666-701 Renata Cristina Castro Cruz verfasserin aut Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. Cardiopatias Congênitas Insuficiência da Valva Mitral/cirurgia Hipertensão Pulmonar Reoperação Insuficiência da Valva Tricúspide/cirurgia Cardiopatia Reumática Diseases of the circulatory (Cardiovascular) system Bruna Silva Cordeiro verfasserin aut Felipe de Souza Santos verfasserin aut Caroline Rodrigues Fernandes verfasserin aut Julia Maria Alves Gama verfasserin aut Ana Marice Teixeira Ladeia verfasserin aut In Arquivos Brasileiros de Cardiologia Sociedade Brasileira de Cardiologia (SBC), 2004 (DE-627)320623572 (DE-600)2023015-1 16784170 nnns https://doi.org/10.5935/abc.20190184 kostenfrei https://doaj.org/article/081c38894c4b4436bd0b0b297948d074 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005017102&lng=en&tlng=en kostenfrei https://doaj.org/toc/1678-4170 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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10.5935/abc.20190184 doi (DE-627)DOAJ072318457 (DE-599)DOAJ081c38894c4b4436bd0b0b297948d074 DE-627 ger DE-627 rakwb eng por RC666-701 Renata Cristina Castro Cruz verfasserin aut Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. Cardiopatias Congênitas Insuficiência da Valva Mitral/cirurgia Hipertensão Pulmonar Reoperação Insuficiência da Valva Tricúspide/cirurgia Cardiopatia Reumática Diseases of the circulatory (Cardiovascular) system Bruna Silva Cordeiro verfasserin aut Felipe de Souza Santos verfasserin aut Caroline Rodrigues Fernandes verfasserin aut Julia Maria Alves Gama verfasserin aut Ana Marice Teixeira Ladeia verfasserin aut In Arquivos Brasileiros de Cardiologia Sociedade Brasileira de Cardiologia (SBC), 2004 (DE-627)320623572 (DE-600)2023015-1 16784170 nnns https://doi.org/10.5935/abc.20190184 kostenfrei https://doaj.org/article/081c38894c4b4436bd0b0b297948d074 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005017102&lng=en&tlng=en kostenfrei https://doaj.org/toc/1678-4170 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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10.5935/abc.20190184 doi (DE-627)DOAJ072318457 (DE-599)DOAJ081c38894c4b4436bd0b0b297948d074 DE-627 ger DE-627 rakwb eng por RC666-701 Renata Cristina Castro Cruz verfasserin aut Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. Cardiopatias Congênitas Insuficiência da Valva Mitral/cirurgia Hipertensão Pulmonar Reoperação Insuficiência da Valva Tricúspide/cirurgia Cardiopatia Reumática Diseases of the circulatory (Cardiovascular) system Bruna Silva Cordeiro verfasserin aut Felipe de Souza Santos verfasserin aut Caroline Rodrigues Fernandes verfasserin aut Julia Maria Alves Gama verfasserin aut Ana Marice Teixeira Ladeia verfasserin aut In Arquivos Brasileiros de Cardiologia Sociedade Brasileira de Cardiologia (SBC), 2004 (DE-627)320623572 (DE-600)2023015-1 16784170 nnns https://doi.org/10.5935/abc.20190184 kostenfrei https://doaj.org/article/081c38894c4b4436bd0b0b297948d074 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005017102&lng=en&tlng=en kostenfrei https://doaj.org/toc/1678-4170 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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10.5935/abc.20190184 doi (DE-627)DOAJ072318457 (DE-599)DOAJ081c38894c4b4436bd0b0b297948d074 DE-627 ger DE-627 rakwb eng por RC666-701 Renata Cristina Castro Cruz verfasserin aut Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. Cardiopatias Congênitas Insuficiência da Valva Mitral/cirurgia Hipertensão Pulmonar Reoperação Insuficiência da Valva Tricúspide/cirurgia Cardiopatia Reumática Diseases of the circulatory (Cardiovascular) system Bruna Silva Cordeiro verfasserin aut Felipe de Souza Santos verfasserin aut Caroline Rodrigues Fernandes verfasserin aut Julia Maria Alves Gama verfasserin aut Ana Marice Teixeira Ladeia verfasserin aut In Arquivos Brasileiros de Cardiologia Sociedade Brasileira de Cardiologia (SBC), 2004 (DE-627)320623572 (DE-600)2023015-1 16784170 nnns https://doi.org/10.5935/abc.20190184 kostenfrei https://doaj.org/article/081c38894c4b4436bd0b0b297948d074 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005017102&lng=en&tlng=en kostenfrei https://doaj.org/toc/1678-4170 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR |
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Cardiopatias Congênitas Insuficiência da Valva Mitral/cirurgia Hipertensão Pulmonar Reoperação Insuficiência da Valva Tricúspide/cirurgia Cardiopatia Reumática Diseases of the circulatory (Cardiovascular) system |
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Renata Cristina Castro Cruz @@aut@@ Bruna Silva Cordeiro @@aut@@ Felipe de Souza Santos @@aut@@ Caroline Rodrigues Fernandes @@aut@@ Julia Maria Alves Gama @@aut@@ Ana Marice Teixeira Ladeia @@aut@@ |
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Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. 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Renata Cristina Castro Cruz |
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RC666-701 Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease Cardiopatias Congênitas Insuficiência da Valva Mitral/cirurgia Hipertensão Pulmonar Reoperação Insuficiência da Valva Tricúspide/cirurgia Cardiopatia Reumática |
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Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease |
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Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease |
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predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to chronic rheumatic heart disease |
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Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease |
| abstract |
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. |
| abstractGer |
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. |
| abstract_unstemmed |
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant. Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion: The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes. |
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