Usporedba ishoda zamjene aortnog zaliska klasičnim postupkom i minimalno invazivnim pristupom u pretilih pacijenata

master's thesis

• Title (english): Comparison of outcomes of aortic valve replacement with a classical procedure and a minimally invasive technique in obese patients
• Author: Ana Ninčević
• Mentor: Hrvoje Gašparović (mentor)
• Committee member: Davor Mijatović (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: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Cilj ovog rada bio je usporediti ishode nakon operacije aortnog zaliska klasičnim postupkom i minimalno invazivnim pristupom u pretilih pacijenata. U ovu retrospektivnu studiju bilo je uključeno 411 pacijenata s izoliranom zamjenom aortnog zaliska i tjelesnim indeksom mase većim od 30 kg/m2 na Klinici za kardijalnu kirurgiju Kliničkog bolničkog centra Zagreb, operiranih u periodu od 2009. do 2020. godine.
Hipoteza je glasila kako pretili pacijenti nakon operacije aortnog zaliska klasičnim postupkom imaju češće perioperativne komplikacije u odnosu na pretile pacijente operirane minimalno invazivnim pristupom.
Statistički analizirani podaci bili su: EuroScore2, trajanje ekstrakorporalne cirkulacije, vrijeme klemane aorte, 30-dnevni mortalitet, broj dana provedenih u Jedinici intenzivnog liječenja, postoperativna fibrilacija atrija, kontinuirana venska hemodijaliza, mehanička potpora cirkulaciji, postoperativno ugrađeni pace-maker, mehanička ventilacija te infekcija rane. Obrađenim podacima dokazano je kako postoji statistički značajna razlika u pacijenata operiranih minimalno invazivnim pristupom u odnosu na one pacijente operirane konvencionalnim pristupom za broj dana provedenih na Jedinici intenzivnog liječenja (p=0,040), za postoperativnu fibrilaciju atrija (p=0,000) i postoperativnu kontinuiranu vensku hemodijalizu (p=0,036). Ne postoji statistički značajna razlika za 30-dnevni mortalitet (p=0,888) što govori u prilog sigurnosti odabira minimalno invazivne kirurgije kod zamjene aortnog zaliska.

Abstract (english)

Aim of this study was to compare the outcomes after aortic valve surgery using the classical procedure and the minimally invasive approach in obese patients. This retrospective study included 411 patients with isolated aortic valve replacement and a body mass index greater than 30 kg/m2 at the Department of Cardiac Surgery of the Clinical Hospital Center Zagreb, operated between 2009 and 2020.
The hypothesis was that patients after aortic valve surgery with a classical procedure had more frequent perioperative complications compared to obese patients operated with a minimally invasive approach.
Statistically analyzed data were: Euroscore2, length of extracorporeal circulation, aortic clamp time, 30-day mortality, number of days spent in the Intensive Care Unit, postoperative atrial fibrillation, continuous venous hemodialysis, mechanical circulatory support, postoperative implanted pacemaker, mechanical ventilation, and wound infection. The processed data proved that there is a statistically significant difference in patients operated with a minimally invasive approach compared to the patients operated with a conventional approach for the number of days spent in the Intensive Care Unit (p=0.040), for postoperative atrial fibrillation (p=0.000) and for postoperative continuous venous hemodialysis (p=0.036). There is no statistically significant difference for 30-day mortality (p=0.888), which speaks in favor of the safety of choosing minimally invasive surgery for aortic valve replacement.

• Keywords: kirurška zamjena aortnog zaliska; minimalno invazivna kardijalna kirurgija; pretilost
• Keywords (english): surgical aortic valve replacement; minimally invasive cardiac surgery; obesity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:612273
• 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: 2023-01-26 08:47:59