[Changes in the aortic prosthesis surgical risk].
Between May 1963 and December 1976, 889 patients underwent single valve aortic replacement by prosthesis. Hospital (30 day) mortality fell, with an exponential decrease (r = 0.94, p less than 0.01) to 4 per cent in 1976. Early risk factors are studied, taking into account the changes affecting them respectively over the time period considered. The average age of the patients increased but did not significantly affect operative mortality. Cardio-thoracic ratio, sex and the duration of extracorporeal circulation had little or no prognostic value. Only classification in class IV of the N.Y.H.A. and the type of valvular disease (severe incompetence) were of clearly pejorative significance. Most deaths occurred early in a context of signs of poor cardiac output, severe disturbances of ventricular rhythym, visceral (digestive) syndromes and/or thrombotic complications. They were characterised at autopsy by sub-endocardial haemorrhagic lesions. The prevalence of these lesions and that of early deaths appeared to decrease with techniques for myocardial protection during the operation.
D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000401:mortality / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012306:Risk
Evolution du risque opératoire des prothèses aortiques.