Cardiac valve replacement. The rationale for earlier operation

Area of Science:

• Cardiology
• Cardiac Surgery
• Biomedical Engineering

Background:

• Valvular heart disease significantly impacts patient quality of life and survival.
• Cardiac valve replacement is a common intervention for severe valvular heart disease.

Purpose of the Study:

• To evaluate the long-term outcomes and mortality associated with cardiac valve replacement.
• To assess the efficacy of prosthetic valves in improving patient function and survival.

Main Methods:

• A retrospective analysis of 138 patients undergoing single or double cardiac valve replacement.
• Procedures maintained normothermia, coronary perfusion, and cardiac beating.
• Patients were followed for at least one year, with an average follow-up of 4.5 years.

Main Results:

• Hospital mortality was 3.6%.
• Late mortality was 27%, with 75% attributed to progressive cardiac disease.
• Prosthetic valve dysfunction accounted for 4% of late deaths.
• Only 50% of patients showed significant long-term improvement, with many remaining symptomatic.

Conclusions:

• Despite low operative risk and reliable prosthetic valves, long-term outcomes are concerning.
• High late mortality and poor functional results question the strategy of delaying surgery.
• Earlier cardiac valve replacement is advised to prevent irreversible myocardial damage.