Evaluation of recovery of the functional class and modification of echocardiographic parameters and morbimortality in patients with mitral valve cardiopathy who underwent surgery at the San Ignacio Hospital

OBJECTIVE: to describe the functional results and morbi-mortality in patients with mitral valve disease who underwent surgery at the San Ignacio Hospital from 2005 to 2009. METHODS: we reviewed the surgical registry of the Cardiovascular Surgery Service of San Ignacio Hospital during the years described. From it, we obtained information from the identity documents to access information from the patients medical records. We reviewed the records of patients treated at the Hospital from January 2005 to October 2009 with mitral valve disease diagnosis at admission. From this documentation and tracking data we obtained the statistics. RESULTS AND CONCLUSIONS: heart valve disease is a common and complex disease, which requires clear norms for evaluation and monitoring, in addition to appropriate criteria to take the patient to surgery at the most appropriate time, select the type of prosthesis that best suits age and weigh the risk of anticoagulation management as predicted by international studies. The average age of patients undergoing surgery at the Hospital San Ignacio is around 60.4 years. Women are the most affected by mitral valve disease. The highest percentage of patients seen come from Bogotá. The mitral pathology more intervened is mitral insufficiency in 74% of cases. The most common surgical management is the mitral valve replacement, with 58% of cases, and of these with mechanical valve in 55.5% of cases. The most commonly used prostheses are mechanical and from these, ONX prostheses prevail in 59.8% over the mechanical. After the surgery, the shift from functional class I to II is remarkable in the majority of patients. The clinical improvement is not reflected in an echocardiographic change; the changes in the size of the cavity and the ejection fraction are maintained. Patients who died were elderly, with low ejection fraction, severe pulmonary hypertension and left atrial dilation, as well as very complex pathologies with co-morbidities. Given these results, as the literature suggests, without having necessarily a causal relationship, we found that patients with mitral valve disease should be brought more prior to surgery in relation to the time when they were taken, either by prolonged treatment by the cardiology service or a delay in the consultation prior to the occurrence of all modification of volumes and functional damage that increase the risk of the procedure and decrease the likelihood of involution of cardiac damage.