Objective: To study the factors associated with long-term cardiovascular support after mitral valve replacement (MVR) under artificial circulation (AC). Material and methods: The study included patients who underwent elective cardiac surgery. Exclusion criteria were: age younger than 18 years or older than 80 years, pre-existing severe cardiac or renal dysfunction, pre-existing anemia requiring blood transfusion, chronic inflammatory diseases, long-term treatment with steroids, chronic liver disease, active infection or sepsis, emergency or repeated surgery, planned therapy with extracorporeal detoxification methods. The study included 146 patients with mitral valve insufficiency who underwent mitral valve replacement surgery at the “V.Vakhidov Republican Scientific and Practical Medical Center of Surgery”. The average age of patients was 41.1±3.0 years. The patients were predominantly male: 81 (55.5%). Results: A total of 58 (39.7%) patients developed prolonged cardiovascular pharmacological support. These patients were older (p<0.02), had a higher EuroSCORE II (p<0.0001), more often had LVEF ≤30% (p<0.0001) and higher preoperative pulmonary hypertension (p<0.0001). Preoperative amiodarone use (p=0.007) was also more common in this group. Supported patients were more likely to experience difficulty weaning from CPB (p<0.0001), had longer aortic occlusion time (p=0.0280), CPB time (p=0.01) and anesthesia duration (p=0.01). During surgery, they received higher doses of norepinephrine (p<0.0001) and epinephrine (p=0.04). Patients with support had higher intraoperative fluid intake (p=0.0007). Lactate levels after CPB were higher (p=0.005) and hematocrit was lower (p=0.0005). In the postoperative period, the duration of mechanical ventilation (p<0.0001), ICU stay (p<0.0001) and hospital stay (p<0.0001) were longer in patients with support. A significant association was found between support and the development of acute kidney injury (p=0.049). Conclusion: Factors associated with prolonged cardiovascular pharmacological support after MVP include higher EuroSCORE II, decreased LVEF≤30%, severe preoperative PH, preoperative amiodarone use, difficulty weaning from CPB, prolonged aortic and CPB occlusion time, high doses of norepinephrine and epinephrine during surgery, elevated lactate and low hematocrit after CPB, and positive fluid balance in the first 24 hours after surgery.
| Mualliflar | Ибадов Равшан Алиевич, Ибрагимов Сардор Хамдамович, Эргашев Сухроб Панжи ўғли |
|---|---|
| Jurnal | Journal of cardiorespiratory research/Kardiorespirator tadqiqotlar jurnali |
| Nashr sanasi | 2024-11-25 |
| Jild | 5 |
| Son | 3 |
| Til | Rus |
недостаточность митрального клапана, протезирование митрального клапана, периоперационный период, эхокардиография, гемодинамика, инфузионная терапия, факторы риска, mitral valve insufficiency, mitral valve replacement, perioperative period, echocardiography, hemodynamics, infusion therapy, risk factors, mitral qopqoq yetishmovchiligi, mitral qopqoqni protezlash, operatsiyadan keyingi davr, exokardiyografiya, gemodinamika, infuzion terapiya, xavf omillari
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects the joints and can lead to destruction of joint tissue, disability and reduced quality of life in patients. Timely diagnosis of RA is…
The aim of the study is to study the daily profile of blood pressure (ABPM) in patients with arterial hypertension (AH) and chronic kidney disease (CKD), depending…
In order to assess peak inspiratory flow (PIF) in 100 patients with obstructive respiratory pathology as part of the selection of an inhalation device for optimizing inhalation respiratory therapy, a functional study of…
This scientific work reviewed the literature of foreign and national scientific works devoted to coronary artery anomalies. In recent years, the features of the development and course of coronary heart disease, in…
Along with the increase in the number of patients, an increasing number of them continue to describe symptoms such as fatigue, palpitations, decreased physical activity, shortness of breath, chest pain, neurocognitive…
This scientific work examines the literature of foreign and national scientific papers on the peculiarities of the development and clinical course of coronary heart disease (CHD) in patients with coronary artery…
Combined forms of these pathologies are often the result of the simultaneous manifestation of a number of danger components, the leading of which are considered to be tobacco use, untreated asthma, as well as the…
This article may focus on the pathological conditions associated with shoulder injuries in canoeing and kayaking. Currently, shoulder joint injury is one of the most common pathologies found among major joint injuries…
In this study, echocardiographic signs of myocardial remodeling were evaluated in patients with acute ST-segment elevation myocardial infarction, depending on the presence of obesity. 91 patients with acute ST-segment…
Coronary heart disease is the leading cause of death worldwide. The World Health Organization (WHO) reported that coronary heart disease was responsible for approximately nine million deaths in 2016. Developed and…
Journal of cardiorespiratory research/Kardiorespirator tadqiqotlar jurnali — barcha maqolalar