V Kadinov, R Topalova, S Nikova, V Popov
Scripta Scientifica Medica   unpublished
With the development of cardiac surgery in Bulgaria with every coming year there are more and more operated patients versus the general number of non-operated with acquired valvular heart disease. The aim of this study was to check up what is the clinical condition, professional ability and late prognosis of operated versus non-operated patients with acquired valvular heart disease treated in Department of Cardiology and Rheumatology with Intensive Care Unit in the Medical University of Varna
more » ... ring 1988. A group of 92 patients with acquired valvular heart disease was investigated. Thirty-two (16 males and 16 females at the mean age of 49,2 years) were operated. Non-operated were 60 patients (22 males and 38 females at the mean age of 49,8 years). From all investigated patients 53 were with mitral valve disease; 18 with aortic valve disease and 21 with a disease of mitral and aortic valves. All patients were under physician's control. By means of a questioning protocol all patients were checked uponce. The diagnosis, the indications for operation , the outcome, the functional class (NYHA) and the professional route were put under analysis. Under analysis were put also the reasons for which some patients were not operated: too late (NYHA III-IV); rheumatic activity; patient's refuse; NYHA l-ll; other contraindications. The results were checked statistically by means of alternative analysis. Twenty-seven (84,36%) from the operated patients improved their functional class (NYHA) after surgical treatment. In the group of patients who were not operated there was no improvement-27 (45%) were without change in their functional class and 26 (43,33%) were in a worsen state. Seven (11,66%) died. It was very impressive that patients who had indications for surgical treatment in 1988 (23 patients) but refused it, got worse in a very high percentage (74%) in 1991 and only 26% were without change. Nevertheless high percentage of operated patients with improved functional class still there were too many of them retired as invalids (65,63%). Among non-operated this figure was 53,33% and the difference with operated patients was statistically