Heart valve replacement improved 8-10 year survival, increased LVEF by 7.5%, improved NYHA class (I-II from 57.5% to 77.7%), with age, valve type, NYHA III-IV, and AF predicting poor outcomes.
Does heart valve replacement surgery improve survival, cardiac function, and quality of life in adult patients?
Heart valve replacement surgery provides significant long-term improvements in cardiac function and quality of life, though preoperative factors like advanced NYHA class, age, and atrial fibrillation predict poorer survival.
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Background To investigate the long‐term prognosis and influencing factors in adult patients undergoing heart valve replacement surgery. Methods A total of 153 adult patients who underwent heart valve replacement surgery were subjected to long‐term follow‐up. Clinical data were collected, and postoperative complications as well as changes in cardiac function indicators (left ventricular ejection fraction LVEF and left ventricular end‐diastolic diameter LVEDD) during the follow‐up period were recorded. The Quality of Life (QoL) scale was used to evaluate patients’ quality of life. The primary clinical outcome was the survival rate, and risk factors affecting survival were analyzed. Results Long‐term (8–10 years) follow‐up of patients who underwent valve replacement surgery revealed that preoperative NYHA functional Class III–IV, age, valve type, and atrial fibrillation (AF) were independent predictors of poor outcomes ( p < 0.05). Cardiac function improved significantly: the proportion of patients with NYHA functional Class I–II increased from 57.5% to 77.7%, LVEF rose from 52.5 ± 8.3% to 60 ± 5%, and LVEDD decreased from 58.2 ± 8.5 mm to 48 ± 6 mm (all P < 0.01). The incidence of infective endocarditis remained low (cumulative 2.9% over 8–10 years). New‐onset AF increased from 10.3% at 1 year to 20.4% at 8–10 years, and persistent AF rose from 20.3% preoperatively to 35.0%. Quality of life improved significantly, with 85.4% (88/103) of patients reporting higher scores and 80.6% (83/103) achieving normal levels. Conclusion Heart valve replacement surgery can significantly prolong patient survival, improve cardiac function, and enhance quality of life. Valve type, patient age, preoperative NYHA class, and the presence of atrial fibrillation are risk factors for prognosis.
Xinyu Zhang (qui,) relatou outro. A substituição da válvula cardíaca melhorou a sobrevivência a 8-10 anos, aumentou a LVEF em 7,5%, melhorou a classe NYHA (I-II de 57,5% para 77,7%), com idade, tipo de válvula, NYHA III-IV e FA prevendo resultados ruins.
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