EARLY POST OPERATIVE VALVULAR PATIENT

MODIFIED DEVAGA’S REPAIR FOR MODERATE TO SEVERE TR IS A COST-EFFECTIVE MANEUVER.

Abstract

Rheumatic Heart Disease is affecting the tricuspid valve almost as equally as it
affects the other valves of the heart and the fact is that the single valvular disease of the heart
is rare in our population. Objectives: To determine the cost effectiveness of modified devagia
repair in relief of post operative valvular patient. Period: 2009-2014. Setting: Faisalabad Institute
of cardiology Faisalabad, Method: All the patients with mitral valve disease having concomitant
tricuspid valve regurgitation operated upon. Average age of 14 years to 45 years without gender
discrimination. Result: A total of 380 patients were studied having concomitant mitral and
tricuspid disease. Out of which 276 patients had moderate to severe tricuspid regurgitation on
per-operative digital assessment for which modified DeVaga’s repair was essential and done.
Only 104 patients had moderate tricuspid regurgitation on per-operative digital assessment
which was the main population of address in our study. Out of these, 76 patients were decided
for modified DeVaga’s repair due to their moderate tricuspid regurgitation and 28 patients were
left alone without modified DeVaga’s repair due to their mild to moderate tricuspid regurgitation.
Then their early post operative course was monitored in terms of ICU stay and their functional
recovery after operation. Patients with modified DeVaga’s repair for moderate tricuspid
regurgitation showed 30-42 hours early weaning of inotropes and mobilization from ICU than
the patients without modified DeVaga’s repair for mild to moderate tricuspid regurgitation. It is
thus evident that modified DeVaga’s repair for moderate tricuspid regurgitation saved hours
of ICU stay, cost of ICU treatment, man hours of doctors, nurses & paramedical staff showing
good post surgical functional recovery as well. Conclusions: Modified DeVaga’s repair for
moderate tricuspid regurgitation has a cost effective impact in the treatment of valvular patients
causing early and good functional recovery after valvular replacement procedures, saving man
hours of Cardiac surgeons, Nurses, Paramedical staff, patients and thus their cost of treatment.