Kết quả phẫu thuật thay van hai lá cơ học tại bệnh viện Hữu nghị Việt Đức

Objectives: Assessment of clinical features and laboratory findings; early and mid-term results of patients with mitral valve replacement at Viet Duc Hospital (Using Saint Jude Master mechanical valve). Material and method: Cross-section survey, retrospective and perspective from 2006 to 2010 in 413 patients. Results: Clinical features: Mean age 45.03 + or - 10.73. In which female 56.4 percent and 42.5 percent of them within reproductive period. Prevalence of reoperated and operated after other catherterizations like percutaneous baloon valvulotomy; open valvulotomy; mitral valve repair/replacement is high:13.07 percent; 20.34 percent and 2.42 percent respectively. Most of patients came in severe state: 81 patients with NYHA III - IV; 38.26 percent patients took more than 10 years of medications before operating; 83.29 percent patients with atrial fibrilations. Laboratory findings: Chest X-ray: 99.03 percent patients with heart/chest index or = 0.5; Cardiac Ultrasonography: Dilated left atrial, mean 59.44 + or - 14.32 mm; Mean Pulmonary pressure 51.03 + or - 15.88mmHg; Aortic valve damage was caught in 45.76 percent patients; tricuspid regurgitation or = 2/4 in 55.9 percent patients. Results of surgery: Mortality rate is low, early 0.24 percent and mid-term 1.78 percent; Morbidity rate is relatively low: Bleeding-reoperation 2.18 percent; mechanical valve obstruction 0.24 percent; sternum infection 0.97 percent; wound infection 6.54 percent; Improved clinical features: NYHA decended from 2.03 + or - 0.48 to 1.75 + or - 1.14; 85.21 percent patients gain weight after operation; improved laboring ability in 88.76 percent patients; improved quality of life in 78.7 percent patients. Improved laboratory findings: Left atrial diameter decended from 56.03 + or - 10.95mm to 47.04 + or - 9.83mm; Pulmonary pressuredecended from 49.27 + or - 15.26 mmHg to 33.18 + or - 6.94 mmHg; Maximum mitral valve gradient decended from18.09 + or - 7.57 mmHg to 10.65 + or - 3.40 mmHg. Conclusion: SJM mechanical valve replacement have good haemodynamic, low morbidity, low gradient. Early and mid-term results of mechanical valve replacement at Viet Duc hospital is relatively good however need futher examinations of long-term results.