Investigation On The Current Status Of Delay In Patients With Valvular Heart Disease In First Hospital Of Shanxi Medical University

Objective:Surgery is the fundamental treatment for heart valve diseases.For a long time,most patients failed to receive surgical treatment at the right time for surgery,which increased the risk of surgery and failed to maximize the benefits of surgery,The majority of patients with valvular heart disease are still adults,which bear most of the family and social responsibilities.The loss or decline of its labor force means the lack of social and family functions.Mobilizing patients with surgical indications to have surgery at the best time can reduce the above problems.To study the current status of surgical treatment of patients with valvular heart disease,and analyze the relationship between NYHA class and surgery delay.Methods:We retrospectively analysed the clinical data of 252 patients undergoing heart valve surgery in the Department of Cardiothoracic Surgery of the First Hospital of Shanxi Medical University from January 2014 to December 2019,including 111 males and 141 females.The surgical patients were divided into delayed operation group and non-delayed operation group,and statistical analysis was performed based on medical experience and demographic data.Results:252 patients delayed from 1 month to 35 years,median delay time is 2.5 years.From onset to diagnosis and then to surgery,the proportion of patients with NYHA II gradually decreased.There were 161 cases(63.9%)with secondary TR in 252 patients,and 135cases(53.6%)with AF,137 cases(54.4%)with pulmonary hypertension,33 cases(13.1%)with thrombosis in the left atrium,19cases(7.5%)with systemic embolism.230 cases(91.3%)had delayed surgery,and only 22 cases(8.70%)had not.210 patients(91.3%)had a NYHA Ⅱ class at the onset in delayed group,while 15 cases(68.2%)in the undelayed group,the difference is statistically significant(P=0.004),OR=4.90,95%CI1.78～13.4.57cases(41.0%)in the patient delayed group had a NYHA Ⅱ class at the time of diagnosis,68cases(74.7%)in patient undelayed group,(P=0.000).92 cases(68.1%)in the medical delayed group had a NYHA Ⅱ class at the time of diagnosis,33 cases(34.7%)in medical undelayed group,(P=0.000),OR=4.02,95%CI2.31～7.01.Conclusion:Most patients with valvular heart disease failed to receive surgery at the right time.Ther is relationship between the milder symptoms of heart failure at the onset of illness and surgical delay.There was no significant difference in the proportion of NYHA Ⅱ class between the delayed group and the non-delayed group at the onset of illness.However,the proportion of NYHA II class in the delayed group was significantly lower than that in the non-delayed group at the time of diagnosis,this might be the result of the patient delay.Mild symptoms(NYHA Ⅱ class)at diagnosis are related to medical delay after diagnosis...