Loading...
Please wait, while we are loading the content...
Similar Documents
Pulmonary-Systemic Pressure Ratio Correlates with Morbidity in Cardiac Valve Surgery
| Content Provider | Scilit |
|---|---|
| Author | Schubert, Sarah A. Mehaffey, J. Hunter Booth, Alexander Yarboro, Leora T. Kern, John A. Kennedy, Jamie L. W. Ailawadi, Gorav Mazimba, Sula |
| Copyright Year | 2019 |
| Description | Journal: Journal of cardiothoracic and vascular anesthesia Pulmonary hypertension portends worse outcomes in cardiac valve surgery; however, isolated pulmonary artery pressures may not reflect patients’ global cardiac function accurately. To better account for the interventricular relationship, the authors hypothesized that patients with greater pulmonary-systemic ratios (mean pulmonary arterial pressure)/(mean systemic arterial pressure) would correlate with worse outcomes after valve surgery. Retrospective cohort study. Single academic hospital. The study comprised 314 patients undergoing valve surgery with or without coronary artery bypass grafting (2004-2016) with Society of Thoracic Surgeons predicted risk scores and preoperative right heart catheterization. None. The pulmonary-systemic ratio was calculated as follows: mean pulmonary arterial pressure/mean systemic arterial pressure. Patients were stratified by pulmonary-systemic ratio quartile. Logistic regression was used to assess the risk-adjusted association between pulmonary-systemic ratio or mean pulmonary arterial pressure. Median pulmonary-systemic ratio was 0.33 (Q1-Q3: 0.23-0.65); median pulmonary arterial pressure was 29 (21-30) mmHg. Patients with the highest pulmonary-systemic ratio had the highest rates of morbidity and mortality (p < 0.0001). A high pulmonary-systemic ratio was associated with longer duration in the intensive care unit (p < 0.0001) and hospital (p < 0.0001). After risk-adjustment, pulmonary-systemic ratio and pulmonary arterial pressure were independently associated with morbidity and mortality, but the pulmonary-systemic ratio (odds ratio 23.88, p = 0.008, Wald 7.1) was more strongly associated than the pulmonary arterial pressure (odds ratio 1.035, p = 0.011, Wald 6.5). The pulmonary-systemic ratio is more strongly associated with risk-adjusted morbidity and mortality in valve surgery than pulmonary arterial pressure. By integrating ventricular interactions, this metric may better characterize the risk of valve surgery. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379101/pdf http://www.jcvaonline.com/article/S1053077018308267/pdf |
| Ending Page | 682 |
| Page Count | 6 |
| Starting Page | 677 |
| ISSN | 10530770 |
| e-ISSN | 15328422 |
| DOI | 10.1053/j.jvca.2018.08.190 |
| Journal | Journal of cardiothoracic and vascular anesthesia |
| Issue Number | 3 |
| Volume Number | 33 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2019-03-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of cardiothoracic and vascular anesthesia Critical Care Medicine Cardiac Catheterization/intervention Cardiac Function, Physiology Pulmonary Vascular Resistance/hypertension |
| Content Type | Text |
| Resource Type | Article |
| Subject | Anesthesiology and Pain Medicine Cardiology and Cardiovascular Medicine |
