Risk Factors for Postoperative Acute Kidney Injury in Patients Undergoing Redo Cardiac Surgery Using Cardiopulmonary Bypass

Zhao, Can; Li, Yuntao; Pan, Gang; Xu, Jie; Liu, Shen; Xiao, Yao

doi:10.3390/jcdd9080244

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…Cardiac surgery-associated acute kidney injury (CSA-AKI) occurs in nearly one-third of patients and represents one of the most important negative predictors of short-and long-term outcomes [26,27]. A recent authoritative article on patients referred for redo surgeries reported that AKI occurred in up to 54.3% of the cases, with renal replacement therapy required in 19.0% [28]. This compares favorably with data shown in our larger cohort.…”

Section: Discussionsupporting

confidence: 73%

Prognostic Implication of Preoperative Anemia in Redo Cardiac Surgery: A Single-Center Propensity-Matched Analysis

Rubino

Santo

Montella

et al. 2023

JCDD

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Preoperative anemia has been associated with increased morbidity and mortality after cardiac surgery, but little is known about its prognostic value in the setting of redo procedure. A retrospective, observational cohort study of prospectively collected data was undertaken on 409 consecutive patients referred for redo cardiac procedures between January 2011 and December 2020. The EuroSCORE II calculated an average mortality risk of 25.7 ± 15.4%. Selection bias was assessed with the propensity-adjustment method. The prevalence of preoperative anemia was 41%. In unmatched analysis, significant differences between the anemic and nonanemic groups emerged in the risk for postoperative stroke (0.6% vs. 4.4%, p = 0.023), postoperative renal dysfunction (29.7% vs. 15.6%, p = 0.001), a need for prolonged ventilation (18.1% vs. 7.2%, p = 0.002), and high-dosage inotropes (53.1% vs. 32.9%, p < 0.001) along with both length of ICU and hospital stay (8.2 ± 15.9 vs. 4.3 ± 5.4 days, p = 0.003 and 18.8 ± 17.4 vs. 14.9 ± 11.1, p = 0.012). After propensity matching (145 pairs), preoperative anemia was still significantly associated with postoperative renal dysfunction, stroke, and the need for high-dosage inotrope cardiac morbidity. Preoperative anemia is significantly associated with acute kidney injury, stroke, and the need for high-dosage inotropes in patients referred for redo procedures.

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Section: Discussionsupporting

confidence: 73%

Prognostic Implication of Preoperative Anemia in Redo Cardiac Surgery: A Single-Center Propensity-Matched Analysis

Rubino

Santo

Montella

et al. 2023

JCDD

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“…In addition, a study conducted in China has reported that CPB time is independently linked to an increased risk of acute kidney injury following surgery for acute DeBakey Type I aortic dissection (43). Therefore, for high-risk patients undergoing AVR, reducing the ACC and CPB times may confer substantial advantages in using the Perceval valve, particularly for patients with pre-existing organ damage and infections or for those undergoing redo surgery (44,45). Two meta-analyses (30, 34) anchored on the comparison of the sutureless and rapid-deployment aortic valves in SURD-AVR had been published before our study was done.…”

Section: Discussionmentioning

confidence: 99%

Sutureless vs. rapid-deployment valve: a systemic review and meta-analysis for a direct comparison of intraoperative performance and clinical outcomes

Wang

Xie

Zhang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundSutureless and rapid-deployment valves are bioprostheses anchoring within the aortic annulus with few sutures, and they act as a hybrid of conventional surgical and transcatheter valves under aortic valve replacement. Considering that the 3F Enable valve is now off-market, the only two sutureless and rapid-deployment valves available on the world marketplace are the Perceval and Intuity valves. However, a direct comparison of the function of these two valves eludes researchers.PurposeAgainst this background, we performed this systematic review and meta-analysis comparing the intraoperative performance and early clinical outcomes between the Perceval valve and the Intuity valve under sutureless and rapid-deployment aortic valve replacement.MethodsWe systematically searched electronic databases through PubMed/MEDLINE, OvidWeb, Web of Science, and Cochrane Central Register of Controlled Trials (from the establishment of the database to November 17, 2022, without language restriction) for studies comparing the sutureless valve (the Perceval) and the rapid-deployment valve (the Intuity) under aortic valve replacement. Our primary outcomes were early mortality and postoperative transvalvular pressure gradients. The secondary outcomes were defined to include aortic cross-clamp and cardiopulmonary bypass time, paravalvular leak (any paravalvular leak, moderate-to-severe paravalvular leak) after aortic valve replacement, need for pacemaker implantation, postoperative neurological events (stroke), and intensive care unit stay.ResultsThis meta-analysis included ten non-randomized trials with 3,526 patients enrolled (sutureless group = 1,772 and rapid-deployment group = 1,754). Quality assessments were performed, with the mean scores of the studies reading 6.90 (SD = 0.99) out of 9 according to the Newcastle–Ottawa Scale. Compared with rapid-deployment aortic valve replacement, sutureless aortic valve replacement was associated with higher mean and peak transvalvular pressure gradients postoperatively. In contrast, aortic cross-clamp and cardiopulmonary time were needed less in sutureless aortic valve replacement vs. rapid-deployment aortic valve replacement. There was no evidence of significant publication bias observed by the funnel plot and Egger's test.ConclusionsFor postoperative hemodynamics, sutureless aortic valve replacement was associated with increased mean and peak transvalvular pressure gradients compared with rapid-deployment aortic valve replacement. In sharp contrast, sutureless aortic valve replacement significantly reduced the amount of time needed for fixing the aortic cross-clamp and the cardiopulmonary bypass procedure.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022343884.

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“…Yaptığımız çalışmada da uzamış perfüzyon süresine sahip grubun hastanede kalış süresinin daha fazla olduğunu saptadık. Yapılan bazı çalışmalarda KPB süresinin akut böbrek hasarı için bağımsız bir risk faktörü olduğu belirtilmektedir (5,(13)(14)(15)(16). Xu ve ark.…”

Section: Bulgular Ve Tartişmaunclassified

“…( 16) yaptıkları çalışmada KPB eşliğinde yeniden/tekrar (revizyon) kalp cerrahisi yapılan hastalarda postoperatif akut böbrek hasarı için risk faktörlerini belirlemeye çalışmışlardır. Çalışmalarında; yüksek AST, ameliyattan önceki 2 hafta içinde yapılan koroner anjiyogram ve uzamış KPB süresinin, tekrar kalp cerrahisi geçiren hastalarda artmış postoperatif akut böbrek hasarı ile ilişkili olduğunu belirtmişlerdir (16). Yaptığımız çalışmada ise bu çalışmaların aksine perfüzyon süresi ile ABY arasında bir ilişki saptayamadık, bunun da cerrahi sırasındaki diğer ilişkili faktörlerden kaynaklanabileceğini düşünmekteyiz.…”

Section: Bulgular Ve Tartişmaunclassified

Kardiyopulmoner Bypass Eşliğinde Kalp Kapak Cerrahisi Uygulanan Hastalarda Perfüzyon Süresinin Postoperatif Sonuçlar Üzerine Etkisi

Amaç,

Bağış

2023

Bingöl Üniversitesi Sağlık Dergisi

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Kardiyopulmoner bypass (KPB) eşliğinde mekanik mitral kapak veya mekanik aort kapak replasmanı operasyonları yapılmaktadır. KPB eşliğinde kalp kapak replasmanı uygulanmış hastalarda KPB/perfüzyon süresinin kardiyak cerrahi sonrası erken dönem morbidite ve mortalite ile ilişkili olduğu düşünülmektedir. Bu retrospektif çalışmada KPB eşliğinde mekanik kalp kapak replasmanı uygulanmış hastaların KPB/perfüzyon süresinin erken dönem postoperatif sonuçlar üzerine etkisinin değerlendirilmesi amaçlandı. KPB eşliğinde kalp kapak cerrahisi uygulanmış, toplam 116 hasta retrospektif olarak dahil edildi. Hastaların ortalama perfüzyon süreleri hesaplandı. Ortalama perfüzyon süreleri üzerinden hastalar iki gruba ayrıldı (Ortalama perfüzyon süresinin üstünde perfüzyon süresi olanlar bir grup, ortalama sürenin altında perfüzyon süresi olanlar ikinci grup). Hastaların biyokimyasal, hematolojik ve diğer verileri gruplar arasında karşılaştırıldı. Daha uzun perfüzyon süresine sahip grubun pacemaker, defibrilasyon ve inotrop ihtiyacı, ES transfüzyonu ve hastanede kalış süresinin daha fazla olduğu, ayrıca ALT, GGT ve pH değerleri de daha yüksekti (p0.05). Sonuç olarak daha uzun KPB/perfüzyon süresi, ilişkilendirmede nedensellik anlamına gelmese de, perfüzyon süresinin mümkün olduğunca kısa tutulması veya kabul edilebilir sınırlar içerisinde tutulması gerektiğini düşünmekteyiz.

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Risk Factors for Postoperative Acute Kidney Injury in Patients Undergoing Redo Cardiac Surgery Using Cardiopulmonary Bypass

Cited by 4 publications

References 35 publications

Prognostic Implication of Preoperative Anemia in Redo Cardiac Surgery: A Single-Center Propensity-Matched Analysis

Prognostic Implication of Preoperative Anemia in Redo Cardiac Surgery: A Single-Center Propensity-Matched Analysis

Sutureless vs. rapid-deployment valve: a systemic review and meta-analysis for a direct comparison of intraoperative performance and clinical outcomes

Kardiyopulmoner Bypass Eşliğinde Kalp Kapak Cerrahisi Uygulanan Hastalarda Perfüzyon Süresinin Postoperatif Sonuçlar Üzerine Etkisi

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