Of the 44 necropsies which were carried out in patients submitted to valvar surgery in 199 0 at InCór (Instituto do Coração), the following clinical causes of death were found in Mitral patients: coagulopathy and bleeding in 11 cases; low cardiac output in 7; cardiogenic shock in 5; septic shock in 3; failure of multiple organs in 3; acute respiratory distress syndrom (ARDS) in 2; severe ventricular arrythmia in 2, and pulmonary thromboembolism in 1. In aortic patients: coagulopathy and bleeding in 5 cases; cardiogenic shock in 2; septicaemia in 3; ruptured micotic aneurism in 1; stroke in 1, and ventricular arrhythmia in 1. In mitroaortic patients: coagulopathy and bleeding in 2 cases; pulmonary thromboembolism in 2; septicaemia in 1; severe ventricular arrythmia in 1, and ARDS in 1. The following anatomopathological causes of death were observed. In mitral patients: hemorrhagic shock in 13 cases; failure of multiple organs in 4; septic shock in 3; broncopneumonia in 4; acute myocardial infarction (AMI) in 3; cardiogenic shock in 3; cerebral hemorrahage in 1, and ARDS in 1. In aortic patients: endocarditis in 3 cases: hemorrhagic shock in 2; cerebral hemorrhage in 2; AMI in 1; cardiogenic shock in 1; septicaemia in 1; acute respiratory distress syndrom (ARDS) in 1, and acute dissection of the aorta, with coagulopathy in 1. In mitroaortic patients: failure of multiple organs in 2 cases; pulmonary thromboembolism in 2; ARDS in 1; hemorrhagic shock in 1, and endocarditis in 1. We concluded that there was correlation between the clinical and anatomopathological diagnoses in 36 patients, corresponding to 82 % of the cases, the principal cause of death being due to hemorrhagic shock. An important observation which was made in this study, was that 11 (25%) patients had some form of chronic hepatopathy which had not previously diagnosed from the clinical laboratory study. Some of the patients which developed clinically unexplained low cardiac output presented subendocardial infarct as an anatomopathological finding.
heart valves; heart valves