การศึกษาผลภายหลังการผ่าตัดหัวใจแบบเปิด ในโรงพยาบาลราชบุรี

บทคัดย่อ

Background : Open heart surgery has been performed with low morbidity and mortality due to improve- ment technique and quality of cardiac surgical care.

Objective : To study patients’ characteristics, variation of heart diseases, type of operations and operative outcome after open heart surgery.

Design : Retrospective descriptive study

Materials and Methods : The medical records of patients who underwent open heart surgery between October 2008 and June 2009 at Ratchaburi Hospital were reviewed. The pre-operative characteristics, underly-ing diseases, pre-operative cardiac risk factors, type of operation, hospital and ICU length of stay (LOS), posto-perative complications, rate of re-hospitalization, hospital mortality rate and short-term clinical outcomes were reviewed.

Results : There were 14 patients (10 females, 4 males) with mean age of 27.3 ± 8.7 years (range 13-41 years). The New York Heart Association class (NYHA class) I, ll, lll were 2 (14.3%), 11 (78%) and 1 (7.1%) res- pectively. There were 8 patients (57.1%) were acquired heart disease. Pulmonary hypertension was the most common preoperative cardiac risk factor (57.1%, n = 8) followed by atrial fibrillation (42.9%, n = 6), chronic pulmonary diseases was the most common preoperative underlying diseases (14.3%, n = 2). Most of operations were mitral valve surgery (28.6%). Mean ICU stay was 3.2 days. Nine patients (64.3%) could be extubated within 6 hours after operations and 92.8% of patients could be discharged within 14 days after the operations. Cardiac arrhythmia that needed medical treatment was the most common postoperative complications. The hospital mortality did not occurred in these patients. The average follow-up period was 8.6 months (range from 3-9 months). Rate of re-hospitalization was 7.1%. All of patients were in NYHA class I postoperatively.

Conclusion : Initial experience of open heart surgery at Ratchaburi Hospital revealed acceptable morbidity and mortality rate on various operative procedures.