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巴西的心脏瓣膜手术——旁路登记分析

Valve Heart Surgery in Brazil - The BYPASS Registry Analysis.

作者信息

Zilli Alexandre Cabral, Guizilini Solange, Rocco Isadora S, Santo José Amalth do Espírito, Berwanger Otavio, Kalil Renato Abdala Karam, Jatene Fabio Biscegli, Cavalcanti Alexandre Biasi, Santos Renato Hideo Nakagawa, Gomes Walter J

机构信息

Universidade Federal de São Paulo Escola Paulista de Medicina Hospital São Paulo São Paulo SP Brazil Discipline of Cardiovascular Surgery, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo - EPM-UNIFESP, São Paulo, SP, Brazil.

Instituto de Pesquisa do Hospital do Coração São Paulo SP Brazil Instituto de Pesquisa do Hospital do Coração - IP-HCor, São Paulo, SP, Brazil.

出版信息

Braz J Cardiovasc Surg. 2020 Feb 1;35(1):82-90. doi: 10.21470/1678-9741-2019-0408.

Abstract

OBJECTIVE

To analyze the profile and outcomes of patients who underwent valve heart surgery in Brazil, using information retrieved from the Brazilian Registry of Cardiovascular Surgeries in Adults (BYPASS Registry) database.

METHODS

This is a multicenter cohort study, evaluating 920 patients submitted to heart valve surgery. Demographics and postoperative clinical outcomes were assessed and compared to estimate mortality risk using the European System for Cardiac Operative Risk Evaluation (EuroSCORE).

RESULTS

Isolated aortic valve replacement was the most frequently performed surgery (34%), followed by isolated mitral valve replacement (24.9%). Valve repair was performed in 21% of mitral procedures. Minimally invasive access was performed in 1.6% and the most frequent postoperative complications were arrhythmias (22.6%), infections (5.7%), and low-output syndrome (5.1%). Operations covered by the public health system accounted for 80.8% and the hospital mortality rate was 7.3%.

CONCLUSION

The most frequent isolated valve surgery in Brazil is the aortic valve replacement by conventional open access and the rheumatic disease is still the main etiology for valve surgery. The BYPASS Registry has a fundamental role to provide information on the profile of patients with valve heart disease in our country in order to delineate adequate strategies for health promotion and resource allocation for cardiac surgery.

摘要

目的

利用从巴西成人心血管外科注册数据库(BYPASS注册数据库)中检索到的信息,分析在巴西接受心脏瓣膜手术的患者的概况和手术结果。

方法

这是一项多中心队列研究,评估了920例接受心脏瓣膜手术的患者。评估了人口统计学和术后临床结果,并使用欧洲心脏手术风险评估系统(EuroSCORE)进行比较以估计死亡风险。

结果

单纯主动脉瓣置换术是最常进行的手术(34%),其次是单纯二尖瓣置换术(24.9%)。21%的二尖瓣手术进行了瓣膜修复。1.6%的手术采用了微创入路,最常见的术后并发症是心律失常(22.6%)、感染(5.7%)和低心排血量综合征(5.1%)。公共卫生系统覆盖的手术占80.8%,医院死亡率为7.3%。

结论

在巴西,最常见的单纯瓣膜手术是通过传统开放入路进行的主动脉瓣置换术,风湿性疾病仍然是瓣膜手术的主要病因。BYPASS注册数据库在提供我国心脏瓣膜病患者概况信息方面发挥着重要作用,以便为心脏手术制定适当的健康促进策略和资源分配方案。

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