Obstructive Sleep Apnea Increases the Perioperative Risk of Cardiac Valve Replacement Surgery: A Prospective Single-Center Study

Ding, Ning; Ni, Buqing; Wang, Hong; Ding, Wen; Xue, Rong; Wang, Lin; Zhang, Kai; Zhang, Shijiang; Zhang, Xilong

doi:10.5664/jcsm.6182

Cited by 18 publications

(25 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Undiagnosed OSA is an incognitive risk factor for prolonged ICU stay after TAAD repair. Although the mechanism has not been elucidated thoroughly, results from previous studies have indicated that OSA is associated with postoperative complications after cardiac and non-cardiac surgeries [10][11][12], and this might prolong ICU stay and worsen surgical outcomes. The current study shows that severe OSA predicts postoperative hypoxemia, which in turn is a strong predictor of prolonged ICU stay.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have reported that obstructive sleep apnoea (OSA) is associated with the onset of aortic dissection through arterial dysfunction, hypertension, and augmented negative thoracic pressure [7][8][9]. Patients with OSA can have poor short-term prognosis as they are at risks of developing hypoxemia after cardiac and non-cardiac surgeries [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is Obstructive Sleep Apnoea Associated with Hypoxemia and Prolonged ICU Stay after Type A Aortic Dissection Repair?

Xin

Chen

et al. 2021

Preprint

View full text Add to dashboard Cite

Background : Although obstructive sleep apnoea (OSA) is prevalent among patients with aortic dissection, its prognostic impact is not yet determined in patients undergoing major vascular surgery. We aimed to investigate the association of OSA with hypoxemia and with prolonged intensive care unit (ICU) stay after type A aortic dissection (TAAD) repair. Methods: This study enrolled 83 patients who underwent TAAD repair. OSA diagnosis was confirmed by a preoperative STOP-BANG questionnaire and a sleep test performed within 90 days postoperatively. OSA was defined as an apnoea hypopnea index (AHI) of ≥15/h, while an AHI of >30/h was defined severe OSA. Hypoxemia was defined as an oxygenation index (OI) of <200 mmHg, 6 h postoperatively and prolonged ICU referred to an ICU stay of >72 h. Multivariable analysis was performed to assess the association of OSA with hypoxemia and prolonged ICU stay. Results: OSA was diagnosed in 41 patients (49.4%), which was consistent with the detection by using a preoperative STOP-BANG score of ≥4 (Kappa=0.424, P<0.01). Hypoxemia occurred postoperatively in 56 patients (67.5%). Postoperatively hypoxemia developed mostly in OSA patients (52.4% vs. 83.0%, P<0.01), and particularly in those with severe OSA ( 52.4% vs. 90.5%, P<0.01). The postoperative OI could fairly predict a prolonged ICU stay (area under the curve, 0.719; 95% CI 0.595-0.843; P=0.002). Severe OSA was a predictor of both postoperative hypoxemia (odds ratio [OR] 6.65; 95% CI 1.56-46.26, P<0.01) and prolonged ICU stay (OR 5.58; 95% CI 1.54-20.24, P<0.01). Conclusions: OSA was common in patients with TAAD. Severe OSA was predictive of hypoxemia and prolonged ICU stay after TAAD repair. The STOP-BANG score may offer diagnostic clues to OSA in patients with TAAD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Obstructive Sleep Apnoea Associated with Hypoxemia and Prolonged ICU Stay after Type A Aortic Dissection Repair?

Xin

Chen

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…However, we fully agree that the associated morbidity was not negligible, with significant postoperative complications and increased length of stay. Sleep-disordered breathing is highly prevalent in obese patients [ 8 ] with associated upper airway muscle weakness, vascular endothelial dysfunction, cardiac arrhythmia, alveolar hypoventilation and sensitivity to anaesthetic medications leading to sudden cardiovascular death, myocardial infarction, stroke, worsening overall postoperative recovery and higher pacemaker use [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Heyde’s syndrome: An enigma

Khazi¹,

Siddiqi²,

Karaly³

et al. 2021

Journal of the Saudi Heart Association

View full text Add to dashboard Cite

Heyde’s syndrome (HS) is described as the association between recurrent bleeding from angiodysplasia of the gastrointestinal tract and aortic stenosis. Aortic valve replacement has been reported to stop the bleeding. In unfit patients, the options available are interventional or conservative management. We hereby report an elderly obese patient with severe comorbidity with complicated HS involving a narrow aortic root. She underwent left ventricular outlet myomectomy and aortic root replacement to promote better forward flow and prevent restenosis and recurrence of symptoms. She was discharged home symptom-free despite being on coumadin anticoagulants.

show abstract

“…Multiple studies have demonstrated that OSA is associated with postoperative complications including respiratory events, cardiac complications, intensive care unit admissions, and increased length of hospital stay. [2][3][4][5][6][7][8][9] Within the elective surgical population, it is estimated that 20% to 70% have OSA, and approximately 80% are undiagnosed at the time of surgery. 10,11 Patients with undiagnosed OSA may unknowingly be at increased risk for perioperative complications.…”

Section: Introductionmentioning

confidence: 99%

“…In particular, patients presenting for surgery and undergoing general anesthesia may be at risk for significant postoperative events. Multiple studies have demonstrated that OSA is associated with postoperative complications including respiratory events, cardiac complications, intensive care unit admissions, and increased length of hospital stay . Within the elective surgical population, it is estimated that 20% to 70% have OSA, and approximately 80% are undiagnosed at the time of surgery .…”

Section: Introductionmentioning

confidence: 99%

Clinical use of the STOP‐BANG questionnaire to determine postoperative risk in veterans

et al. 2018

View full text Add to dashboard Cite

show abstract

Obstructive Sleep Apnea Increases the Perioperative Risk of Cardiac Valve Replacement Surgery: A Prospective Single-Center Study

Abstract: RVHD patients with OSA have an increased incidence of perioperative adverse events. OSA was independently associated with overall postoperative recovery, respiratory insufficiency, and higher rate of postoperative pacemaker use, while CSA was not associated with postoperative events.

Cited by 18 publications

References 27 publications

Is Obstructive Sleep Apnoea Associated with Hypoxemia and Prolonged ICU Stay after Type A Aortic Dissection Repair?

Is Obstructive Sleep Apnoea Associated with Hypoxemia and Prolonged ICU Stay after Type A Aortic Dissection Repair?

Heyde’s syndrome: An enigma

Clinical use of the STOP‐BANG questionnaire to determine postoperative risk in veterans

Contact Info

Product

Resources

About