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dc.contributor.advisorCamacho Mackenzie, Jaime 
dc.contributor.advisorCarreño Jaimes, Marisol 
dc.creatorMedina Garcia, Gabriel Santiago 
dc.date.accessioned2016-02-16T16:15:34Z
dc.date.available2016-02-16T16:15:34Z
dc.date.created2016-01-25
dc.date.issued2016
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/11716
dc.descriptionIntroducción: A partir de la década de los cincuenta el manejo de la enfermedad valvular presenta cambios significativos cuando se incorporan los reemplazos valvulares tanto mecánicos como biológicos dentro de las opciones de tratamiento quirúrgico (1). Las válvulas biológicas se desarrollaron como una alternativa que buscaba evitar los problemas relacionados con la anticoagulación y con la idea de utilizar un tejido que se comportara hemodinámicamente como el nativo. Este estudio está enfocado en establecer la sobrevida global y la libertad de reoperación de la válvula de los pacientes sometidos a reemplazo valvular aórtico y mitral biológicos en la Fundación Cardioinfantil - IC a 1, 3, 5 y 10 años. Materiales y métodos: Estudio de cohorte retrospectiva de supervivencia de pacientes sometidos a reemplazo valvular aórtico y/o mitral biológico intervenidos en la Fundación Cardioinfantil entre 2005 y 2013. Resultados: Se obtuvieron 919 pacientes incluidos en el análisis general y 876 (95,3%) pacientes con seguimiento efectivo para el análisis de sobrevida. La edad promedio fue 64años. La sobrevida a 1, 3, 5 y 10 años fue 95%,90%,85% y 69% respectivamente. El seguimiento efectivo para el desenlace reoperación fue del 55% y se encontró una libertad de reoperación del 99%, 96%, 93% y 81% a los 1, 3, 5 y 10 años. No hubo diferencias significativas entre la localización de la válvula ni en el tipo de válvula aortica empleada. Conclusiones: La sobrevida de los pacientes que son llevados a reemplazo valvular biológico en este estudio es comparable a grandes cohortes internacionales. La sobrevida de los pacientes llevados a reemplazo valvular con prótesis biológicas en posición mitral y aortica fue similar a 1, 3, 5 y 10 años.
dc.description.abstractBackground: From the 1950 to present, valvular disease management has shown significant improvements specifically when mechanical and biological heart valve replacements are used together within the surgical treatment options. Biological valves were developed as an alternative to avoid problems associated with anticoagulation and with the purpose of using a tissue that behave hemodynamically like the native. The aim of this study was to determine the overall survival and freedom from valve reoperation in patients undergoing valvular replacement in aortic and/or mitral position at 1, 3, 5 and 10 years. Methods: A historical Cohort of patients who underwent bioprosthetic valve replacement in aortic and/or mitral position, in an institution in Bogota between 2005 and 2013. A descriptive analysis with technical standard for the overall cohort and survival statistics was conducted. Survival was analyzed with the Kaplan Meyer technique, a value of less than 0. 05 was considered significant, which was performed in STATA 1O. Results: 919 patients were included in the overall analysis. 95. 3% (876/919) of effective follow-up for survival analysis. The average age was 64 years. 1-, 3-, 5- and 10-years survival was 95% (832/876), 90% (788/876), 85% (744/876) y 69% (604/876) respectively. The effective follow-up to the outcome reoperation was 55% (509/919) and it was found a freedom from reoperation of 99% (503/509), 96% (488/509), 93% (473/509) y 81% (412/509) at 1, 3, 5 and 10 years. There were no significant differences neither in the valve placement or in the aortic valve prosthesis employed. Conclusions: The survival of patients who underwent biological valve replacement in this study is comparable to large international cohorts. The survival of patients with bioprosthetic valve replacement in aortic and mitral position was similar at 1, 3, 5 and 10 years. Thus, implementation of national databases allowing to comply cohorts of patients with valve replacements for comprehensive and strict monitoring is required.
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectCirugía cardiovascular
dc.subjectPrótesis valvular
dc.subjectEpidemiología clínica
dc.subjectEstudio analítico
dc.subjectAnálisis de Supervivencia
dc.subject.ddcVarias ramas de la medicina, Cirugía  
dc.subject.lembCirugía
dc.titleAnálisis de supervivencia en pacientes con prótesis valvular biológica, Fundación Cardioinfantil-Instituto de Cardiología, Colombia, 2005-2013
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Cirugía Cardiovascular
dc.publisher.programEspecialización en Cirugía Cardiovascular
dc.publisher.departmentFacultad de Medicina
dc.subject.keywordCardiovascular surgery
dc.subject.keywordprosthetic heart valves
dc.subject.keywordclinical epidemiology
dc.subject.keywordanalytical study
dc.subject.keywordsurvival analysis
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.subject.decsCirugía torácica
dc.subject.decsPrótesis valvulares cardíacas
dc.subject.decsEpidemiología
dc.subject.decsServicios de salud del niño
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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