Avtor/Urednik		Dolenc, Jure
Naslov		Predoperativni dejavniki tveganja za menjavo aortne zaklopke pri starostnikih
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2003
Obseg		str. 43
Jezik		slo
Abstrakt		BACKGROUND. The number of elderly patients with degenerative aortic valve stenosis is increasing due to the ageing of the population. Advances in preoperative and postoperative care are reflected in a growing number of patients aged > 70 years undergoing aortic valve replacement (AVR). AlIVI. The current study was undertaken to determine the significance of clinical, echocardiographic, invasive and surgical preoperative predictors of early and late postoperative mortality and of poor functional outcomes after AVR. HYPOTHESIS. Poor postoperative outcome depends on the stage of aortic valve stenosis, co-morbidity and the complexity of surgical procedure. METHODS. Data were reviewed for 235 consecutive patients, 120 women and 115 men, aged 70 to 89 years (mean age 74.7 +- 3.3) who underwent AVR between I January 1, 1997 and December 31, 2001. Patient age, gender, symptoms, New York Heart Association (NYHA) functional class, signs of congestive heart failure, concurrent diseases, cardiac rhythm, left ventricular hypertrophy, echocardiographic characteristics of native valve disease, left ventricular and left atrial dimensions, left ventricular ejection fraction, presence of mitral regurgitation and pulmonary hypertension, preoperative catheterization data, urgency and type ofthe surgical procedure were analysed as possible predictors of outcome. The influence of preoperative and operative variables on outcomes was determined using the bivariate chi2 tests and multvariate logistic regression. The survival rates were determined by the Kaplan-Meier method. RESULTS. Early postoperative (< 30 days) mortality was 11.5%. Multivariate logistic regression showed that chronic renal failure (p = 0.023), poor left ventricular ejection fraction (p = 0.039), pulmonary hypertension (p = 0.001) and combined sargery (p = 0.005) were independent predictors of early mortality. (Abstract truncated at 2000 characters).
Deskriptorji		PREOPERATIVE CARE ATRIAL FIBRILLATION HYPERTROPHY, LEFT VENTRICULAR AORTIC VALVE STENOSIS HEART VALVE PROSTHESIS RISK ASSESSMENT CORONARY DISEASE POSTOPERATIVE COMPLICATIONS KIDNEY FAILURE, CHRONIC CARDIAC OUTPUT, LOW HYPERTENSION, PULMONARY ELECTROCARDIOGRAPHY ECHOCARDIOGRAPHY AGED