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HERDIN Record #: NCR-PHC-18022211265936 Submitted: 22 February 2018 Modified: 22 February 2018

Triple valve surgery: preoperative factors that affect the in-hospital mortality rate for elective triple valve surgery.

Samuel T. Andin

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Background: Triple valve surgery has been considered a complex surgery as they are done usually in rheumatic heart diseases, at least in our setting and literature have shown a relatively high mortality rate. We will attempt here to examine the preoperative factors that may be associated with mortality.

Method: This is a retrospective study done in the Philippine Heart Center on triple valve surgeries from January 2008 to December 2012. Medical records of 116 patients were reviewed. Emergency cases and those with concomitant CABG were excluded from the study. Only the preoperative data were collected and analyzed in relation to mortality.

Results: Inhospital mortality rate was at 12%. The mean age of patients was 40 ± 13 years with male slightly higher in number at 66 (58%) compared to females at 50 (42%). Hypertension was found to be significantly related to mortality (odds ratio 6.0 and p-value 0.002). The echocardiographic parameters such as ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, pulmonary artery pressure and right ventricular fractional area change were not associated with mortality. Higher creatinine levels was associated with mortality was not statistically significant.

Conclusion: Triple valve surgery is a high risk procedure in itself and adding to the fact that this had to be done in cases like rheumatic heart disease makes this a more challenging operation. Careful preoperative selection is crucial as the close monitoring in the perioperative course of the patient.

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Philippine Heart Center Medical Library PHC.R.004.14 Fulltext Print Format