Long-Term Consequences of Postoperative Heart Failure After Surgery for Aortic Stenosis Compared With Coronary Surgery

Vánky, Farkas; Håkanson, Erik; Svedjeholm, Rolf

doi:10.1016/j.athoracsur.2007.01.031

Cited by 29 publications

(49 citation statements)

References 27 publications

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“…The connection we found between PHF and early postoperative morbidity is in accordance with previous studies on other patient categories (14,16,22). The incidence of PHF was 41% in patients with AF undergoing MVS in our study, which is higher than the reported 5-15% of PHF for other cardiac surgery patient groups (23)(24)(25)(26).…”

Section: Discussioncontrasting

confidence: 51%

“…The 2.0% one-year mortality in patients with PHF was lower than the predicted early postoperative mortality indicated by EuroSCORE II (5.8%) and it was considerably lower than in patients with PHF after coronary surgery (25.5%) (16). In patients with PHF after surgery for aortic stenosis, an 8.9% one-year mortality was reported but the mortality rose to 42.2% at the five-year follow-up (16). Obviously the impact of PHF on postoperative mortality is different for different patient groups.…”

Section: Discussionmentioning

confidence: 81%

“…In this study, PHF presented at weaning from extracorporeal circulation and was associated with prolonged respiratory treatment and increased renal impairment. The 2.0% one-year mortality in patients with PHF was lower than the predicted early postoperative mortality indicated by EuroSCORE II (5.8%) and it was considerably lower than in patients with PHF after coronary surgery (25.5%) (16). In patients with PHF after surgery for aortic stenosis, an 8.9% one-year mortality was reported but the mortality rose to 42.2% at the five-year follow-up (16).…”

Section: Discussionmentioning

confidence: 97%

“…Most of the in-hospital mortality after coronary bypass surgery is Boano et al 4 related to PHF, and patients with PHF after surgery for aortic stenosis have a 42% mortality rate at five-year follow-up (16). Our hypothesis was that the Cox-maze IV cryoablation procedure added to MVS is associated with PHF and other adverse short-term outcomes.…”

Section: Introductionmentioning

confidence: 95%

“…Postoperative heart failure (PHF) is one of the major determinants for adverse outcome in cardiac surgery (14)(15)(16). Most of the in-hospital mortality after coronary bypass surgery is Boano et al 4 related to PHF, and patients with PHF after surgery for aortic stenosis have a 42% mortality rate at five-year follow-up (16).…”

Section: Introductionmentioning

confidence: 99%

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Cox-maze IV cryoablation and postoperative heart failure in mitral valve surgery patients

Boano

Aneq

Kemppi

et al. 2016

Scandinavian Cardiovascular Journal

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OBJECTIVE: The indications for and the risk and benefit of concomitant surgical ablation for atrial fibrillation (AF) have not been fully delineated. Our aim was to survey whether the Cox-maze IV procedure is associated with postoperative heart failure (PHF) or other adverse short-term outcomes after mitral valve surgery (MVS). DESIGN: Consecutive patients with AF undergoing MVS with (n = 50) or without (n = 66) concomitant Cox-maze IV cryoablation were analysed regarding perioperative data and one-year mortality. RESULTS: The patients in the Maze group were younger, were in lower NYHA classes, had better right ventricular function and had lower pulmonary artery pressure. The Maze group had 30 min longer median cross-clamp time (CCT) and 50% had PHF compared with 33% in the No-maze group, p = 0.09. Two patients in the No-maze group died within one year of surgery. Congestive heart failure (OR 4.3 [CI 95%: 1.8-10], p < 0.0001) and CCT (OR 1.03 [CI 95%: 1.01-1.04], p = 0.001) were associated with PHF. CONCLUSION: The current data cannot exclude that concomitant cryoablation increases the risk for PHF, possibly by increasing the cross clamp time.

Funding agencies: ALF funding, County Council of Ostergotland, Sweden

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Cox-maze IV cryoablation and postoperative heart failure in mitral valve surgery patients

Boano

Aneq

Kemppi

et al. 2016

Scandinavian Cardiovascular Journal

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Funding agencies: ALF funding, County Council of Ostergotland, Sweden

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Mechanical Heart Failure Therapy

Trimlett

2010

Cardiovascular Critical Care

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Perioperative Anesthesia Management in Secondary Mitral Regurgitation and Heart Failure

Conte

2014

Secondary Mitral Valve Regurgitation

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This chapter provides an overview of the anesthesia and perioperative intensive care management of patients undergoing surgery for secondary mitral regurgitation (SMR).Evidence-based medicine has led to an unprecedented growth in the scientifi c approach to decision making in the belief that it will translate into benefi ts for patients to decrease their risk and improve outcomes (Cheng and Martin, Semin Cardiothoracic Vasc Anesth 9:1-4, 2005). However, clinicians must apply innumerable, complex, and dynamic interventions to the perioperative care of these challenging patients, interventions that are adjusted to achieve a number of physiologic and clinical goals by selecting, titrating, and timely applying many pharmacologic and nonpharmacologic therapies. In doing so clinicians are of course driven by the available evidence, but also by inductive pathophysiologic reasoning, local culture and policies, resource and technology availability, various concerns, beliefs, bias, and random events. While it is clear that outcome of major surgery is affected greatly by surgical prowess and volume (Birkmeyer et al., N Engl J Med 349:2117-2127, in addition, part of the variance in surgical mortality relates to factors beyond surgical skills, namely to all of that complex activity that is the perioperative medicine (Grocott and Pearse Br J Anaesth 108:723-726, 2012). Therefore, albeit only a few nonsurgical interventions have randomized evidence to support their effect in reducing mortality in patients undergoing cardiac surgery (CS) (Landoni et al., Acta Anaesthesiol Scand 5:259-266, 2011), it is believed that perioperative medicine matters.Perioperative management of patients with SMR is accordingly outlined in the text hereafter, with a main focus on hemodynamics along with hints stemming from an integrative approach of the heart interacting with other organ systems. An extensive review of the body of knowledge relevant to the cardiac anesthesiologist and of all the challenges and details of anesthesia and perioperative management in cardiac surgical candidates is beyond the scope of this chapter and can be found in reference cardiac anesthesia and CS texts. Preoperative and intraoperative echocardiographic imaging, as well as minimally invasive mitral valve (MV) surgery and percutaneous Mitra Clip procedures are covered elsewhere in this book

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Long-Term Consequences of Postoperative Heart Failure After Surgery for Aortic Stenosis Compared With Coronary Surgery

Cited by 29 publications

References 27 publications

Cox-maze IV cryoablation and postoperative heart failure in mitral valve surgery patients

Cox-maze IV cryoablation and postoperative heart failure in mitral valve surgery patients

Mechanical Heart Failure Therapy

Perioperative Anesthesia Management in Secondary Mitral Regurgitation and Heart Failure

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