P113 * Clinical outcomes following double and triple valve surgery in Hong Kong

Abstract

Objective: Patients undergoing double and triple valve procedures represent a complex group and early outcomes have shown high mortality in some series (6.9% for first time surgeries: Society of Cardiothoracic Surgeons in Great Britain and Ireland Database 2008). Method: We studied early clinical outcomes in patients undergoing double and triple valve surgery in Prince of Wales Hospital from 1/2006 to 12/2010. Patientsa(euro)(trademark) demographics, automatically generated risk scores, intra and post-operative variables were recorded and collected prospectively. Result: In the study period, 1557 patients underwent cardiac surgery in our institution and 188 patients (12.2%) required double or triple valve surgery. 55% were female and the mean age was 57 (range 20-81). Preoperative logistic EuroSCORE was mean 5.96. Fifteen patients (7.9%) had undergone previous cardiac surgery. 4.3% of patients had associated coronary artery disease and required addition of coronary bypass procedure. Ninety patients presented with Class III/IV NYHA symptoms (47.8%) and 22 (11.7%) had evidence of severe ongoing heart failure. Nineteen patients (10.1%) required urgent or emergency surgery. 2.7% had evidence of pre-operative renal impairment and 4.8% had associated obstructive airways disease. Five patients (2.7%) presented with previous permanent neurological deficit, 7 patients (3.7%) had previously had a neurological event with full recovery and 22.9% had evidence of only fair or poor left ventricular ejection fraction. Mortality was 4.8% (9 patients) for the overall group and for elective operations mortality was 3.6% (6 patients). Reoperation for bleeding was 5.3% overall and 4 patients (2.1%) developed a new post-operative stroke. Three patients (1.6%) required new post-operative dialysis on a temporary basis. Conclusion: Patient requiring double and triple valve surgeries represent a heterogeneous and complex group of patients. They are a significant portion of patients undergoing valve surgery in our Institution. Outcomes in comparison to pre-operative risk scores and International Databases are satisfactory.