Sağ Ventrikül Fonksiyonunun Kardiyovasküler Cerrahide Mortalite ve Reoperasyon Oranları Üzerindeki Etkisi

Yıl 2024, Cilt: 14 Sayı: 4, 388 - 397, 31.12.2024

Muhammet Fethi Sağlam , Emrah Uğuz Kemal Erdoğan , Hüseyin Ünsal Erçelik Murat Yücel , Mete Hıdıroğlu , Erol Sener

https://doi.org/10.31832/smj.1563340

Öz

Amaç: Bu çalışmada, triküspit kapak cerrahisi geçiren hastalarda preoperatif sağ ventrikül (SV) fonksiyonunun mortalite, reoperasyon ve diğer postoperatif sonuçlar üzerindeki etkisinin araştırılması amaçlandı.
Yöntemler: Retrospektif olarak gerçekleştirilen bu çalışmada, triküspit kapak cerrahisi geçiren 100 hasta incelendi. Hastalar, preoperatif SV fonksiyonlarına göre normal, hafif depresif, orta depresif ve ciddi depresif olmak üzere dört gruba ayrıldı. Sağ ventrikül fonksiyonu ekokardiyografik parametrelerle değerlendirildi ve postoperatif mortalite, morbidite, reoperasyon gereksinimi ve ek işlem oranları, cinsiyet ve yaş gibi demografik veriler analiz edildi.
Bulgular: Ciddi depresif SV fonksiyonuna sahip hastalarda mortalite oranları anlamlı derecede yüksek bulundu (p<0.001). Reoperasyon ve ek işlem oranları da SV fonksiyonundaki bozulma ile artış gösterdi (p<0.05). Cerrahi türü (sternotomi veya torakotomi) açısından gruplar arasında anlamlı bir fark bulunamadı (p=0.714).
Sonuç: Sağ ventrikül disfonksiyonu, triküspit kapak cerrahisi geçiren hastalarda postoperatif mortalite ve reoperasyon oranlarını önemli ölçüde artırmaktadır. Preoperatif SV fonksiyonunun dikkatli bir şekilde değerlendirilmesi, cerrahi sonuçların iyileştirilmesinde kritik öneme sahiptir.

Anahtar Kelimeler

Sağ ventrikül disfonksiyonu, triküspit kapak cerrahisi, mortalite, reoperasyon.

Impact of Right Ventricular Function on Mortality and Reoperation Rates in Cardiovascular Surgery

Öz

Objective: This study aimed to investigate the impact of preoperative right ventricular (RV) function on postoperative outcomes such as mortality, reoperation rates, valve size, and other clinical variables in patients undergoing tricuspid valve surgery.
Methods: This retrospective study included 100 patients who underwent tricuspid valve surgery. Patients were categorized into four groups based on preoperative RV function: normal, mildly depressed, moderately depressed, and severely depressed. RV function was assessed using echocardiographic parameters, including tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging (TDI), mean pulmonary artery pressure (MPAB), and valve size. Postoperative outcomes, including mortality and reoperation rates, were analyzed.
Results: Patients with severely depressed RV function had significantly higher mortality rates (p=0.035). Reoperation rates also increased as RV function worsened (p=0.006). No significant difference was found between groups regarding valve size (p>0.05) or the type of surgery (sternotomy or thoracotomy) (p=0.714).
Conclusion: Right ventricular dysfunction significantly increases postoperative mortality and reoperation rates in patients undergoing tricuspid valve surgery. Careful preoperative evaluation of RV function, including valve size, is critical for improving surgical outcomes.

Anahtar Kelimeler

Right ventricular dysfunction, Tricuspid valve surgery, Mortality, Reoperation

Etik Beyan

This study received ethical approval from the 1nd Clinical Research Ethics Committee of Ankara Bilkent City Hospital on 07.06.2023, with decision number TABED-1-24-529. The study, was reviewed and unanimously approved in terms of ethical considerations.

Destekleyen Kurum

Not applicable.

Teşekkür

Not applicable.

Kaynakça

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