Revista argentina de cardiología
versión On-line ISSN 1850-3748
LOWENSTEIN HABER, Diego M et al. Real Facts in Cardiovascular Surgery in Argentina. The XVI CONAREC Registry. Rev. argent. cardiol. [online]. 2010, vol.78, n.3, pp. 228-237. ISSN 1850-3748.
Background The CONAREC and the ESMUCICA studies are the largest multicenter registries performed in Argentina more than 10 years ago. The clinical and surgical advances achieved during the last decade have obliged us to carry out a new national, prospective and multicenter registry to become aware of the characteristics, outcomes, complications and predictors of mortality of patients undergoing cardiac surgery. Objectives To recognize the epidemiologic profile, surgical approach and postoperative outcomes of patients undergoing cardiac surgery in Argentina. Material and Methods This is a prospective, consecutive and multicenter registry performed by residents in Cardiology in 49 centers with cardiovascular surgery facilities. A total of 2553 patients undergoing cardiac surgery were included between September 2007 and October 2008, distributed as follows: coronary artery bypass graft surgery, 1465 patients (57.4%); aortic valve replacement, 359 (14.1%); mitral valve surgery, 169 (6.6%); combined procedure (revascularization-valve surgery), 312 (12.2%); other procedures, 248 (9.7%). Results There were more men (74.9%) than women; mean age was 63±11 years. The prevalence of diabetes was 24.9%, of hypertension 76.3% and of heart failure 17%. Preoperative moderate to severe left ventricular dysfunction was 23.8%, and 19.8% of surgeries were done on an urgent or emergency basis. A 41.9% of coronary artery bypass graft surgeries were done without cardiopulmonary bypass and a mammary artery bypass graft was used in 89%. Mitral valve surgery was indicated due to mitral regurgitation in 81.7% of cases and 63.6% of aortic valve surgeries were due to aortic valve stenosis. Mechanical heart valve prostheses were used in 58% of cases. Patients were hospitalized for a median of 6 days. Major complications occurred in 31.7% of cases (25% in revascularization surgeries and 49.36% in combined procedures) and global mortality was 7.7% (4.3% and 49.36%, respectively). Conclusions This registry demonstrates the real facts in cardiovascular surgery in centers with cardiovascular residents in Cardiology. Mortality and major complications are lower than those reported by previous registers, yet they are still high.
Palabras llave : Cardiovascular Surgery; Mortality; Major Complications; Predictors of Mortality.