Usporedba kvalitete života pacijenata nakon zamjene aortalnog zaliska minimalno invazivnom tehnikom i klasičnim pristupom

master's thesis

• Title (english): Quality of life comparison between patients after minimally invasive and conventional aortic valve replacement
• Author: Filip Štembal
• Mentor: Hrvoje Gašparović (mentor)
• Committee member: Bojan Biočina (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Hrvoje Gašparović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Cilj ove studije bio je usporediti kvalitetu života pacijenata nakon izolirane zamjene aortnog zaliska punom sternotomijom i minimalno invazivnom tehnikom, konkretno, pristupom kroz gornju hemisternotomiju. Hipoteza je bila da pacijenti operirani pristupom kroz gornju hemisternotomiju imaju veću kvalitetu života nakon operativnog zahvata od onih operiranih punom sternotomijom. Promatrana populacija uključivala je pacijente operirane punom sternotomijom u razdoblju između siječnja 2013. i ožujka 2015. te pacijente operirane pristupom kroz gornju hemisternotomiju u razdoblju između listopada 2011. i svibnja 2015 na Klinici za kardijalnu kirurgiju Kliničkog bolničkog centra Zagreb. Pacijenti su telefonski intervjuirani, s ciljem dobivanja podataka o kvaliteti života. Statističkom analizom podataka, utvrđena je statistički značajno viša srednja dob pacijenata operiranih pristupom kroz punu sternotomiju. Srednje vrijeme praćenja pacijenata iz te skupine bilo je statistički značajno kraće nego kod skupine operirane pristupom kroz gornju hemisternotomiju. U skupini pacijenata operiranih pristupom kroz gornju hemisternotomiju, zamijećen je statistički značajno veći broj pušača, dijabetičara te osoba s bikuspidnim aortalnim zaliskom. Srednje intraoperativno vrijeme srčane ishemije i srednji vremenski period korištenja stroja za izvantjelesni krvotok bili su značajno dulji u skupini pacijenata operiranih pristupom kroz gornju hemisternotomiju, dok su srednje vrijednosti postoperativnog troponina T u krvi pacijenata iz navedene skupine bile značajno niže u odnosu na pacijente operirane konvencionalnim pristupom. U skupini pacijenata operiranoj pristupom kroz gornju hemisternotomiju utvrđen je statistički značajno veći broj pacijenata s iznadprosječnom razinom fizičkog funkcioniranja, odnosno boljom kvalitetom života u spomenutoj domeni. Usporedbom grupnih rezultata, također je utvrđena granično statistički značajno bolja kvaliteta života u domeni fizičkog funkcioniranja u skupini pacijenata operiranih minimalno invazivnom tehnikom.

Abstract (english)

The purpose of this study was to compare the quality of life between patients who underwent isolated aortic valve replacement through a full sternotomy and an upper mini-sternotomy. Our hypothesis was that patients who underwent minimally invasive aortic valve replacement had a better postoperative quality of life compared with those who underwent the same procedure through a full sternotomy approach. We included patients operated via the full sternotomy approach between January 2013 and March 2015, and patients operated through an upper hemisternotomy between October 2011 and May 2015 at the Cardiac surgery department, University Hospital Centre Zagreb. Phone call interview was conducted in order to obtain the data on their quality of life. The statistical data analyses revealed that patients in the full sternotomy group were significantly older than the patients from the upper hemisternotomy group. In the upper hemisternotomy group there were statistically significantly more patients who were active smokers as well as those diagnosed with diabetes and those with bicuspid aortic valves. Mean intraoperative cross-clamp time and mean cardiopulmonary bypass time were higher in the upper hemisternotomy group while mean postoperative levels of troponin T remained significantly lower when compared with the full sternotomy group. There were significantly more patients in the upper hemisternotomy group with above average level of physical functioning and therefore better quality of life when compared with patients in the full sternotomy group. Group result comparison also revealed better quality of life in the domain of physical functioning for patients from the upper hemisternotomy group, and the difference between the 2 groups had met the criteria of borderline statistical significance.

• Keywords: minimalno invazivna kardijalna kirurgija; kirurška zamjena aortalnog zaliska; kvaliteta života
• Keywords (english): minimally invasive cardiac surgery; surgical aortic valve replacement; quality of life
• Language: croatian
• URN:NBN: urn:nbn:hr:105:218043
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-10-20 11:02:08