masterThesis
Análisis de supervivencia en pacientes con prótesis valvular biológica, Fundación Cardioinfantil-Instituto de Cardiología, Colombia, 2005-2013
Fecha
2016Autor
Medina Garcia, Gabriel Santiago
Institución
Resumen
Background: From the 1950 to present, valvular disease management has shown significant improvements specifically when mechanical and biological heart valve replacements are used together within the surgical treatment options. Biological valves were developed as an alternative to avoid problems associated with anticoagulation and with the purpose of using a tissue that behave hemodynamically like the native. The aim of this study was to determine the overall survival and freedom from valve reoperation in patients undergoing valvular replacement in aortic and/or mitral position at 1, 3, 5 and 10 years. Methods: A historical Cohort of patients who underwent bioprosthetic valve replacement in aortic and/or mitral position, in an institution in Bogota between 2005 and 2013. A descriptive analysis with technical standard for the overall cohort and survival statistics was conducted. Survival was analyzed with the Kaplan Meyer technique, a value of less than 0. 05 was considered significant, which was performed in STATA 1O. Results: 919 patients were included in the overall analysis. 95. 3% (876/919) of effective follow-up for survival analysis. The average age was 64 years. 1-, 3-, 5- and 10-years survival was 95% (832/876), 90% (788/876), 85% (744/876) y 69% (604/876) respectively. The effective follow-up to the outcome reoperation was 55% (509/919) and it was found a freedom from reoperation of 99% (503/509), 96% (488/509), 93% (473/509) y 81% (412/509) at 1, 3, 5 and 10 years. There were no significant differences neither in the valve placement or in the aortic valve prosthesis employed. Conclusions: The survival of patients who underwent biological valve replacement in this study is comparable to large international cohorts. The survival of patients with bioprosthetic valve replacement in aortic and mitral position was similar at 1, 3, 5 and 10 years. Thus, implementation of national databases allowing to comply cohorts of patients with valve replacements for comprehensive and strict monitoring is required.