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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

ACTUAL RISK IN VALVULAR SURGERY - EXPERIENCE IN OVER 3800 PATIENTS
N. Radovanović, S. Ničin, Lj. Petrović, J. Lavač, J. Selestiansky and B. Mihajlović
University Clinic of Cardiovascular Surgery, Novi Sad, Yugoslavia

During the period of 16 years 3897 patients underwent surgery for valvular heart disease. In 258 patients re-do valvular surgery was performed. Monovalvulopathy was surgically treated in 2068 pts, twofold valvulopathy in 1327 pts and threefold in 502 pts. Operations were performed using the standard technique of cardiopulmonary by -pass. Mild systemic hypothermia cold cardioplegic solution St.Thomas topical hypothermia and our own procedure were routinely used for myocardial protection. Hemodynamic monitoring -Swan Ganz, as well as transesophageal Doppler echocardiography during the operation were also used. We always used transseptal approach to the mitral valve. In aortic valve replacement the orientation of prostheses were perpendicular to the septum and in mitral position antianatomic. Single suture for aortic prostheses and continuous one of mitral valves were performed. Postoperative mortality for this series of 3897 pts was 2,1% (82pts) and for re-do valvular surgery 4,6% (12/258). The lowest operative risk in our series was in monovalvulopathy (1,6%). In twofold valvulopathy postoperative mortality was 2,3% and in threefold 3,6%.
No ptsPM (%)Mitral valvulopathy - repair2661.1 - replacement3441.7Mitro-tricuspid valvulopathy11592.2Aortic-mitral valvulopathy1502.0Aortic-mistral-tricuspid valvulopathy5023.6 Special attention in our surgical strategy was turned to preserving the native valve and to perform reconstructive surgery whenever possible. Our experience in over 3800 valvular patients operated during the period of 16 years shows that nowadays it is possible to perform valvular with minor operative risk.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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