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Influence of preoperative and intraoperative factors on recovery after aortic root surgery

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Abstract

Objective

To determine the influence of intraoperative factors relative to preoperative risk factors on recovery after aortic root replacement (ARR).

Methods

Retrospective review of baseline and intraoperative characteristics was performed of 822 patients at our Aortic Center from 2005 to 2019. Inclusion criteria were all patients age 18 and older who underwent ARR at our institution from 2005 to 2019. The primary endpoint was the aggregate outcome of “failure to achieve uneventful recovery (FUR),” as previously defined.

Results

In total, 207 (25%) patients experienced FUR. The following preoperative and intraoperative variables were significantly associated with FUR in the multivariable analysis: cardiopulmonary bypass time (OR 1.01, 95% CI 1.01–1.02) open chest management (OR 5.67, 95% CI 2.65–12.1), ejection fraction (OR 1.03, 95% CI 1.01–1.04), chronic kidney disease > stage 3a (OR 2.37, 95% CI 1.54–3.63), bicuspid aortic valve (OR 1.54, 95% CI 1.21–1.96), and female sex (OR 1.30, 95% CI 1.06–1.61). Cardiopulmonary bypass time and open chest management were among the top three partial R2 contributors to the logistic regression model variance.

Conclusions

These findings suggest efficacy in using intraoperative parameters to predict postoperative outcomes after ARR.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Medical Center, 177 Fort Washington Ave, New York, NY, 10032, USA

    Isao Anzai, Christian Pearsall, David Blitzer, Adedeji Adeniyi, Yuming Ning, Yanling Zhao, Michael Argenziano, Tsuyoshi Yamabe, Paul Kurlansky, Isaac George, Craig Smith & Hiroo Takayama

  2. Department of Cardiology, Columbia University, New York, NY, USA

    Yuichi Shimada

Authors
  1. Isao Anzai
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  2. Christian Pearsall
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  3. David Blitzer
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  4. Adedeji Adeniyi
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  5. Yuming Ning
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  6. Yanling Zhao
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  7. Michael Argenziano
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  8. Yuichi Shimada
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  9. Tsuyoshi Yamabe
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  10. Paul Kurlansky
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  11. Isaac George
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  12. Craig Smith
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  13. Hiroo Takayama
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Corresponding author

Correspondence to Hiroo Takayama.

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Conflict of interest

Dr. Isaac George has received Institutional funding to Columbia University from Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific, JenaValve. Dr. Isaac George has received speaker honoraria from Zimmer Biomet, Atricure, Neosurgery, Neptune Medical, Abbvie, Johnson & Johnson, Boston Scientific and owns stock in Valcare Medical, Durvena, CardioMech, Vdyne, MitreMedical, MITRx. Dr. Isaac George is a member of Edwards Surgical, Medtronic Surgical, Trisol Medical, Abbvie, Johnson & Johnson, Foldax Medical, Zimmer Biomet, Neosurgery, Abbvie, and Boston Scientific advisory boards. The remaining authors declare that they have no conflicts of interest.

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Anzai, I., Pearsall, C., Blitzer, D. et al. Influence of preoperative and intraoperative factors on recovery after aortic root surgery. Gen Thorac Cardiovasc Surg 72, 104–111 (2024). https://doi.org/10.1007/s11748-023-01957-0

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  • DOI: https://doi.org/10.1007/s11748-023-01957-0

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