Postoperative Infection And Clinical Outcome To The Aortic Valve Disease Combined With Ascending Aorta Dilation

Objective: To summary the patients of cardiac surgery of GuangXi medical university first affiliated hospital with aortic valve disease combined with ascending aorta dilation through the retrospective data analysis,to find out the related risk factors of the related infections and adverse cardiac events occurring the after surgery,and use them to predict it.Methods: Collecting the first affiliated hospital of GuangXi medical university cardiac surgery in June 2012 to January 2019 all of the ascending aorta to expand the merger of aortic valve disease of disease,and in our heart surgical aortic surgery over the same period with the ascending aorta surgical treatment of the patient’s information,and surgery related complications and postoperative follow-up data,using spss17 software for data statistics and draw pictures.Results: There were no significant differences in gender,age,blood pressure,heart rate,cardiac function grading and echocardiography between the infected group and the non-infected group.There were significant differences in extracorporeal circulation time,duration of ventilator use,duration of ICU use and total hospital stay between the two groups.The duration of the above items in the infection group was longer than that in the non-infection group,and there were no significant differences in other conditions,such as operation type,operation time,postoperative hospital stay,postoperative total drainage volume and total blood products used.There was a significant difference between the infected group and the non-infected group in the change of total bilirubin one day after surgery,the change of total bilirubin in the infected group was higher than that in the non-infected group,and there was no significant difference in the change of other postoperative biochemical indexes between the infected group and the non-infected group.Multivariate analysis of the two groups showed that there was a significant difference in the duration of ventilator use between the two groups,and there was no significant difference in extracorporeal circulation time,duration of ICU use,total length of hospital stay,and total bilirubin changes between the two groups.The results of ROC curve analysis indicated that the duration of ventilator use alone had a higher predictive value for infection than the duration of cardiopulmonary bypass,the duration of ICU use,the total length of hospital stay and the change of bilirubin one day after surgery.Univariate analysis of adverse event group and non-adverse event group showed significant difference in LVEDV value between the two groups.The LVEDV value of patients in the adverse event group was higher than that in the non-adverse event group.Other items such as gender,age,cardiac function grading and the remaining items of cardiac ultrasound examination showed no significant difference between the two groups.There was no significant difference in surgical outcome between the adverse event group and the non-adverse event group.There was no significant difference in postoperative biochemical indexes between the two groups.Multivariate analysis between the two groups indicated that LVEDV values were significantly different between the two groups.For the occurrence of postoperative adverse cardiac events,the area under the ROC curve predicted by LVEDV value was 0.836.Conclusions: 1.For patients with aortic valve disease complicated with ascending aorta dilation,there are many surgical methods for the surgeon to choose in clinical work,and different surgical methods have certain strategies in selection,which should be comprehensively considered according to the patient’s ascending aorta dilation and degree of lesion.2.The ventilator was used for a long time,which was an independent risk factor for the occurrence of related infections in patients with aortic valve lesions combined with ascending aortic dilatation in our hospital after surgery,and its predictive value for infection was 53.00 h.3.High LVEDV value is an independent risk factor for adverse cardiac events in patients with aortic valve disease combined with ascending aortic dilatation in our hospital after surgery,and its predictive value for adverse cardiac events is 266.00 ml.