Leenders, P.M. (Philemon) (2012) De incidentie en voorspellers van klepgerelateerde complicaties na een mitralisklepvervanging bij volwassenen met een aangeboren hartafwijking : Een multicenter onderzoek. thesis, Medicine.
Full text available on request.Abstract
Background: Little is known about the incidence of valve related complications post-MVR (mitral valve replacement) for adult patients with congenital heart disease. As a result, risk stratification for patients who are considered for MVR is difficult. We investigate the impact of patient- and valve related factors on the risk of complications post-MVR. Material and methodology: From all adult patients with congenital heart disease, who have undergone MVR in one of the six participating heart surgical centers, in the period from 1983 until 2011, baseline variables (demographic, surgical and preoperative clinical variables) were documented from patient’s charts. Also, valve related complications were classified according established criteria. The population was divided in two groups according to the presence or absence of valve related complications. Differences in preoperative clinical variables (ECG, echocardiography and exercise tolerance) were investigated. Finally, the mortality within the population was analyzed, as well as the complications arising with patients that had deceased. Results: In total, 91 MVR procedures were performed in 86 patients. The baseline diagnosis was AVSD in 34,9%, congenital mitral stenosis in 18,6% and Marfan syndrome in 14,0% of the cases. In the end 48 MVR procedures (52,7%) remained free from valve related complications. Event free survival 10 years post-MVR was 60%. Preoperative ECG, echocardiography and exercise tolerance did not predict the occurrence of valve related complications (respectively p=0,11, p=0,20 and p=0,63). The group with complications had on average a smaller initial valve prosthesis, but this difference was found to be borderline significant (p=0,07) Out of 86 patients, 24 underwent re-MVR (27,9%). Younger patients with initially a smaller prosthetic valve, had re-MVR more often (respectively p<0,001 and p<0,001). Also patients with the baseline diagnosis MS (mitral stenosis) underwent re-MVR more often (p<0,001). Mechanical bileaflet valves are more durable than other types of prosthetic valves (p<0,001). Nine patients deceased (10,5%), of which the cause of death was valve related in three of the cases (3,3%). Conclusion: None of the valve- and patient related factors were predictors of valve related complications. Young patients with a small valve size had to undergo re-MVR more frequently. Furthermore, patients with MS as baseline diagnosis and patients who received a different valve than the mechanical bileaflet during the initial MVR had to undergo a re-MVR more
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider and Melle, Dr. J.P. van and Afdeling congenitale cardiologie and Cardio Research UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/275 |
Actions (login required)
 |
View Item |