Complicated postoperative course in isolated tricuspid valve surgery: looking for predictors
| Autor: | Andrea Blasio, Michele De Bonis, Fabrizio Monaco, Ottavio Alfieri, Stefania Ruggeri, Alessandra Sala, Davide Schiavi, Marta Bargagna, Roberta Meneghin, Roberto Lorusso, Alessandro Castiglioni, Paolo Denti, Andrea Giacomini, Nicola Buzzatti, Mara Scandroglio, Elisabetta Lapenna, Eustachio Agricola, Davide Carino |
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| Přispěvatelé: | CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, Sala, Alessandra, Lorusso, Roberto, Bargagna, Marta, Ruggeri, Stefania, Buzzatti, Nicola, Scandroglio, Mara, Monaco, Fabrizio, Agricola, Eustachio, Giacomini, Andrea, Carino, Davide, Meneghin, Roberta, Schiavi, Davide, Lapenna, Elisabetta, Denti, Paolo, Blasio, Andrea, Alfieri, Ottavio, Castiglioni, Alessandro, De Bonis, Michele |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Multivariate analysis SOCIETY Disease 030204 cardiovascular system & hematology DISEASE RECOMMENDATIONS law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine law Ascites medicine Humans tricuspid replacement tricuspid regurgitation Retrospective Studies Heart Valve Prosthesis Implantation EUROPEAN ASSOCIATION OUTCOMES Univariate analysis Tricuspid valve hospital outcome business.industry isolated tricuspid valve surgery medicine.disease TRENDS Intensive care unit Tricuspid Valve Insufficiency Surgery tricuspid repair Treatment Outcome medicine.anatomical_structure 030228 respiratory system Heart failure HEART Tricuspid Valve medicine.symptom Cardiology and Cardiovascular Medicine business NATIVE VALVULAR REGURGITATION Kidney disease |
| Zdroj: | Journal of Cardiac Surgery, 36(9), 3092-3099. Wiley |
| ISSN: | 0886-0440 |
| DOI: | 10.22541/au.162127343.38741663/v1 |
| Popis: | Background This study aims at better defining the profile of patients with a complicated versus noncomplicated postoperative course following isolated tricuspid valve (TV) surgery to identify predictors of a favorable/unfavorable hospital outcome.Methods All patients treated with isolated tricuspid surgery from March 1997 to January 2020 at our institution were retrospectively reviewed. Considering the complexity of most of these patients, a regular postoperative course was arbitrarily defined as a length-of-stay in intensive care unit less than 4 days and/or postoperative length-of-stay less than 10days. Patients were therefore divided accordingly in two groups.Results One hundred and seventy-two patients were considered, among whom 97 (56.3%) had a regular (REG) and 75 (43.6%) a non-regular (NEG) postoperative course. The latter had worse baseline clinical and echocardiographic characteristics, with higher rate of renal insufficiency, previous heart failure hospitalizations, cardiac operations, and right ventricular dysfunction. NEG patients more frequently needed tricuspid replacement and experienced a greater number of complications (p < .001) and higher in-hospital mortality (13% vs. 0%, p < .001). The majority of these complications were related to more advanced stage of the tricuspid disease. Among most important predictors of a negative outcome univariate analysis identified chronic kidney disease, ascites, previous right heart failure hospitalizations, right ventricular dysfunction, previous cardiac surgeries, TV replacement and higher MELD scores. At multivariate analysis, liver enzymes and diuretics' dose were predictors of complicated postoperative course.Conclusion In isolated TV surgery a complicated postoperative course is observed in patients with more advanced right heart failure and organ damage. Earlier surgical referral is associated to excellent outcomes and should be recommended. |
| Databáze: | OpenAIRE |
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