Post-operative Course of Heart Valve Surgery: From the Intensive Care Unit to Rehabilitation

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (5 June 2023) | Viewed by 1214

Special Issue Editors

Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, 20100 Milan, Italy
Interests: cardiac surgery; mitral valve; cardiac valve surgery; endocarditis
Department of Cardiovascular Surgery, IRCCS Centro Cardiologico Monzino, 20100 Milan, Italy
Interests: cardiac surgery; mitral valve; cardiac valve surgery; coronary artery bypass surgery

Special Issue Information

Dear Colleagues, 

The post-operative course of cardiac valve surgery is as important as the surgery itself. In the immediate post-operative hours it is necessary to monitor cardiac rhythm, blood loss, cardiovascular parameters, neurological status, urine output and many more aspects. Nevertheless, despite optimal care, complications can still arise, creating a barrier to quick discharge.

The current literature has been dealing with post-operative course, especially since the spread of minimally invasive surgical techniques, in order to understand the difference in post-operative outcomes.

Moreover, cardiac rehabilitation has also been given more credit, especially after the COVID-19 pandemic, with the increased use of telecardiology. It permits patients to follow rehabilitation at home, decreasing the spread of infectious diseases such as COVID-19.

Many suggestions have been made over the years regarding the optimal post-operative course after cardiac valve surgery, but there is on-going debate in the literature.

Moreover, nursing care has become even more important in the last year, together with the work of physiotherapists in order to study and understand the perfect timing for moving, for example. In addition, dedicated nursing care might be important to decrease the rates of delirium, especially in older patients.

Our goal is to provide a full picture of the post-operative course of cardiac valve surgery, from the immediate post-operative hours in the cardiac intensive care unit to the rehabilitation clinic, focusing also on the nursing aspects of care.

Dr. Ilaria Giambuzzi
Dr. Giorgia Bonalumi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • heart valve surgery
  • cardiac rehabilitation
  • cardiac intensive care unit
  • postoperative cardiac surgery

Published Papers (1 paper)

Order results
Result details
Select all
Export citation of selected articles as:

Research

16 pages, 1358 KiB  
Article
Three Logistic Predictive Models for the Prediction of Mortality and Major Pulmonary Complications after Cardiac Surgery
by Elena Bignami, Marcello Guarnieri, Ilaria Giambuzzi, Cinzia Trumello, Francesco Saglietti, Stefano Gianni, Igor Belluschi, Nora Di Tomasso, Daniele Corti, Ottavio Alfieri and Marco Gemma
Medicina 2023, 59(8), 1368; https://doi.org/10.3390/medicina59081368 - 26 Jul 2023
Viewed by 1014
Abstract
Background and Objectives: Pulmonary complications are a leading cause of morbidity after cardiac surgery. The aim of this study was to develop models to predict postoperative lung dysfunction and mortality. Materials and Methods: This was a single-center, observational, retrospective study. We retrospectively analyzed [...] Read more.
Background and Objectives: Pulmonary complications are a leading cause of morbidity after cardiac surgery. The aim of this study was to develop models to predict postoperative lung dysfunction and mortality. Materials and Methods: This was a single-center, observational, retrospective study. We retrospectively analyzed the data of 11,285 adult patients who underwent all types of cardiac surgery from 2003 to 2015. We developed logistic predictive models for in-hospital mortality, postoperative pulmonary complications occurring in the intensive care unit, and postoperative non-invasive mechanical ventilation when clinically indicated. Results: In the “preoperative model” predictors for mortality were advanced age (p < 0.001), New York Heart Association (NYHA) class (p < 0.001) and emergent surgery (p = 0.036); predictors for non-invasive mechanical ventilation were advanced age (p < 0.001), low ejection fraction (p = 0.023), higher body mass index (p < 0.001) and preoperative renal failure (p = 0.043); predictors for postoperative pulmonary complications were preoperative chronic obstructive pulmonary disease (p = 0.007), preoperative kidney injury (p < 0.001) and NYHA class (p = 0.033). In the “surgery model” predictors for mortality were intraoperative inotropes (p = 0.003) and intraoperative intra-aortic balloon pump (p < 0.001), which also predicted the incidence of postoperative pulmonary complications. There were no specific variables in the surgery model predicting the use of non-invasive mechanical ventilation. In the “intensive care unit model”, predictors for mortality were postoperative kidney injury (p < 0.001), tracheostomy (p < 0.001), inotropes (p = 0.029) and PaO2/FiO2 ratio at discharge (p = 0.028); predictors for non-invasive mechanical ventilation were kidney injury (p < 0.001), inotropes (p < 0.001), blood transfusions (p < 0.001) and PaO2/FiO2 ratio at the discharge (p < 0.001). Conclusions: In this retrospective study, we identified the preoperative, intraoperative and postoperative characteristics associated with mortality and complications following cardiac surgery. Full article
Show Figures

Figure 1

Back to TopTop