NHỮNG ĐẶC ĐIỂM HẬU PHẪU CẦN LƯU Ý TRONG PHẪU THUẬT HỞ VAN 2 LÁ VỚI PHÂN SUẤT TỐNG MÁU GIẢM (EF ≤ 60%)

Abstract

Objective: Evaluation the hemodynamic variablility and ICU parameters in surgery result of primary mitral valve regurgitation with left ventricular dysfunction (EF ≤ 60%). Material and methods: Retrospective study - cases series, 34 patients primary mitral valve regurgitation with left ventricular dysfunction were operated from 2015 to 2019 at Cho Ray hospital. Results: 35,3% rhematic disease, mitral valve replacement were 26,5%. Median cardiopulmonary bypass time were 128,1 ± 66,1; median aortic cross-clamping time were 94,3 ± 53,3. In 34 cases, there are 2 patients were death, mortality rate were 5,9%, operative complications were 38,2% overall, in there re-explored for bleeding were 2,9%, drainage pericardial effusion and fleural effusion were 11,8% and 22,6%, pneumonia were 8,8%, median intensive care unit stay were 93 hours, median mechanical ventilation support were 24 hours, median inotrope support were 72 hours. There were new arrhythmias, 9 cases with temporary pacing (26,5%), 1 case with permanent pacing (2,9%), 1 case ventricular fibrillation (2,9%). Post-op renal failure were increased 17,7%, aminotransferase were increased 41,2%, median bilirubinemia level were higher two times than pre-op. Conclusions: Surgery of primary mitral valve regurgitation with left ventricular dysfunction increase arrhythmia rate; mechanical ventilation support time and inotrope support time were prolonged; kidney and liver function were influenced significantly. However it provided satisfactory early-term outcome, similar to many cardiac surgery center on the world, specially there are some improved operation techniques and many postoperative support devices.