In-hospital mortality in patients with rheumatic heart disease undergoing double valve replacement

A cardiopatia reumatica e um importante problema de saude publica. Ha escassez de dados sobreinfluencia de variaveis cirurgicas na mortalidade de pacientes reumaticos submetidos dupla-troca valvar (DTV).Objetivo: Identificar possiveis variaveis cirurgicas associadas a mortalidade de pacientes reumaticos submetidos a DTV.Metodos: Estudo retrospectivo de corte transversal, incluindo 104 pacientes >18 anos, com diagnostico previo devalvopatia reumatica, submetidos a cirurgia de DTV no periodo de janeiro de 2007 a dezembro de 2011. A coletade dados utilizou os prontuarios de pacientes do Hospital Ana Nery, Salvador, BA, Brasil.Resultados: Observou-se diferenca estatistica significativa entre os grupos do desfecho (obito intra-hospitalar/alta hospitalar) em relacao as variaveis, respectivamente: tempo de anoxia (minutos) de 149,17±40,99 e 123,99±24,12(p=0,001); tempo de CEC 185,53±54,59 e 157,34±34,62 (p=0,006); e o tempo cirurgico total 350,29±56,69 e 295,23±63,98(p=0,002). Os pacientes que realizaram outro procedimento associado a DTV, no mesmo tempo cirurgico,apresentaram maior mortalidade (n=10; 31,2%), em relacao aos que realizaram apenas a DTV (n=9; 12,8%) (p=0,027).Houve tambem associacao significativa na comparacao de pacientes com reabordagem cirurgica com aqueles querealizaram unica abordagem (p Rheumatic heart disease is a major public health issue. Data on the influence of surgical variables in mortality in rheumatic patients undergoing double valve replacement (DVR) are scarce. Objective: Identify potential surgical variables associated with mortality in rheumatic patients undergoing DVR. Methods: Retrospective cross-sectional study including 104 patients over 18 years, previously diagnosed with rheumatic heart-valve disease, and undergoing DVR surgery from January 2007 to December 2011. Data collection: medical records of patients from HospitalAna Nery, Salvador, Brazil.Results: Outcome groups (in-hospital death vs. hospital discharge) had a significant statistical difference in relation to variables, respectively:anoxia time (in minutes) of 149.17±40.99 and 123.99±24.12 (p=0.001); CPB time 185.53±54.59 and 157.34±34.62 (p=0.006); and totalsurgical time 350.29±56.69 and 295.23±63.98 (p=0,002). Patients who underwent another procedure associated with DVR for the same surgical time showed higher mortality rates (n=10; 31.2%) compared to those who underwent DVR only (n=9, 12.8%) (p=0.027). There was also a significant association when comparing patients with surgical rapprochement with those who underwent one surgery only(p