P4385Diaphragm dysfunction following cardiac surgery: role of ultrasound imaging for initial and follow-up assessment during cardiac rehabilitation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Maranta ◽  
I Cartella ◽  
A Pistoni ◽  
L Cianfanelli ◽  
P Cerea ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Respiratory Cycle ◽  
Diaphragm Dysfunction ◽  
Surgical Interventions ◽  
Diaphragm Function ◽  
The Impact

Abstract Background Diaphragm dysfunction is a common complication of cardiac surgery, often underdiagnosed. Ultrasonography (US) is a promising technique for diaphragmatic assessment. Few trials have been conducted using US after heart surgery and no clear data exist on the recovery of diaphragm function after cardiovascular rehabilitation (CR). Purpose The aim of this study is to evaluate post-cardiac surgery diaphragm dysfunction using US and to assess the impact of an inpatient CR programme on its functional recovery. Methods In a single-centre prospective cohort study 97 consecutive patients hospitalised in our CR Unit were enrolled. 14 patients underwent aortic valve replacement, 38 mitral valve repair or replacement, 14 coronary artery bypass grafting (CABG), 22 combined surgery, and 9 other surgical interventions. We performed diaphragm US at admission and after 10 rehabilitative sessions. The following parameters were assessed: thickening fraction (TF) in B-mode on the right intercostal projections, and excursion, time of inspiration, time of a respiratory cycle and contraction velocity in M-mode on right anterior subcostal projections. Results After cardiac surgery, the incidence of diaphragm dysfunction and paralysis were 60% and 1%, respectively. Patients with TF <20% at admission showed a significant improvement in TF (13.30%, IQR 8.69–17.39 vs 27.27%, IQR 21.05–31.58; p<0.001), excursion (1.67cm, IQR 1.3–2.1 vs 2.23cm, IQR 1.9–2.7; p<0.001), time of inspiration (0.9s, IQR 0.9–1.07 vs 1.01s, IQR 0.87–1.13; p=0.005), time of a respiratory cycle (2.67s, IQR 2.38–3.05 vs 3.07s, IQR 2.68–3.35; p<0.001) and velocity (1.81cm/s, IQR 1.14–2.33 vs 2.24cm/s, IQR 1.92–2.76; p<0.001). On the contrary, in patients with a TF>20%, no additional improvement was observed. In both groups, there was a significant improvement in the parameters of physical performance. In particular, in the group with a TF<20%, the distance covered during the 6MWT (300m, IQR 205–370 vs 555m, IQR 450–612; p<0.001) and the energy cost of physical activity (2.60, IQR 2.13–2.92 vs 4.09, IQR 3.44–4.50; p<0.001) increased while the perception of exertion (Borg Scale 11, IQR 11–13 vs 13, IQR 12–13; p=0.011) was reduced. At the 10th day assessment, 51.5% of the total population had a recovery of diaphragm function, whilst 48.5% had a failure of recovery (TF relative change between admission and discharge <60%). The multivariate analysis identified CABG as an independent predictor of failure of diaphragm recovery (OR 5.44; CI 1.10–26.84, p=0.037). Conclusion US might be a valuable part of routine clinical practice for initial and follow-up assessment of patients after open-heart surgery. CR showed to be an effective strategy to improve diaphragm parameters in patients with post-surgical dysfunction. Progressive evaluation of diaphragm function may drive personalised rehabilitation programmes.

Assessment of diaphragm dysfunction during cardiac rehabilitation after heart surgery: the role of ultrasound imaging

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Maranta ◽  
V Rizza ◽  
I Cartella ◽  
S Pellegrino ◽  
A Bonaccorso ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Functional Recovery ◽  
Heart Surgery ◽  
Respiratory Cycle ◽  
Invasive Technique ◽  
Valve Repair ◽  
Combined Surgery ◽  
Diaphragm Dysfunction ◽  
Diaphragm Function ◽  
The Right

Abstract Background Diaphragm dysfunction is a frequent and underdiagnosed complication of cardiac surgery. It can cause dyspnoea, decreased exercise performance and, in more severe cases, respiratory failure. Ultrasonography (US) is a valuable, non-invasive technique for the assessment of diaphragm function. Only few trials have been conducted using US to evaluate diaphragm functional recovery after cardiovascular rehabilitation (CR). Purpose The aim of the study was to assess with US the incidence of diaphragm dysfunction after heart surgery and to define the impact of an inpatient CR programme on diaphragm functional recovery. Methods We performed a single-centre prospective cohort study, enrolling 185 patients hospitalized in our CR unit: 99 patients underwent mitral valve repair or replacement, 28 tricuspid valve repair or replacement, 53 aortic valve replacement, 30 coronary artery bypass grafting, 59 combined surgery and 14 other surgical procedures. Diaphragm US was performed at admission and after 10 rehabilitative sessions. We assess the following parameters on quiet breathing: excursion, time of inspiration, time of a respiratory cycle and contraction velocity (slope) in M-mode on the right anterior subcostal projections and thickening fraction (TF) in B-mode on the right intercostal projections. TF was defined as [(thickness at end inspiration–thickness at end expiration)/thickness at end expiration]. Results The median excursion at admission was 1.6 cm. Patients with excursion &lt;2 cm (lower limit for the general population) were considered with diaphragm dysfunction. Following cardiac surgery, the incidence of diaphragm dysfunction was 70.8%. Patients with excursion &lt;2 cm at admission gained an important benefit from CR, with a significant improvement in TF (p&lt;0.001), excursion (p&lt;0.001), time of inspiration (p&lt;0.001), time of a respiratory cycle (p&lt;0.001) and slope (p&lt;0.001). Conversely, in patients with excursion ≥2 cm there was no significant improvement in slope (p=0.539) and excursion (p=0.179). At the final assessment, diaphragm function recovered in 50.5% of the patients, whilst 49.5% had a failure of recovery (excursion relative change between admission and discharge &lt;33%). The multivariate analysis identified combined surgery (OR 3.08; 95% CI 1.59–5.99, p=0.001) and post-surgical pneumothorax (OR 3.05; 95% CI 1.23–7.55, p=0.036) as independent predictors of failure of diaphragm function recovery. Conclusions US might be a valuable tool for initial and follow-up assessment of patients after cardiac surgery. CR has been shown to be an effective strategy to improve diaphragm parameters in patients with post-surgical dysfunction. Patients undergoing combined surgery or developing post-surgical pneumothorax might benefit from a personalised rehabilitation programme to improve diaphragm function. Funding Acknowledgement Type of funding source: None

scholarly journals The Impact of Perioperative Viscoelastic Test Application on Blood Product Usage and Outcome in Cardiac Surgery; Regional Cardiac Surgery Center Experience

2021 ◽  
Author(s):  
Murat Aksun ◽  
Saliha Aksun ◽  
Mehmet Ali Çoşar ◽  
Elif Neziroğlu ◽  
Senem Girgin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Experience ◽  
Heart Surgery ◽  
Blood Product ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart ◽  
Blood Products ◽  
Product Use ◽  
The Impact

Objective: Thromboelastography (TEG) is a diagnostic modality that gives information about coagulation. Despite all blood-preserving precautions in open heart surgery there are blood losses and the use of blood and blood products becomes inevitable. TEG is mostly not available in every center and habits, trends and clinical experience in blood use create the possibility of causing unnecessary use of blood and blood products. In this study, it was aimed to determine the effect of the use of thromboelastography on the use of blood and blood products in cardiac surgery. Methods: Two hundred patients between 18-70 years old who underwent open heart surgery were included in the study. After the cardiopulmonary bypass (CPB), the cases were confirmed to have an Activated Clotting Time (ACT) value in the range of 120-150 sec after protamine administration. In 100 patients in the TEG group, the coagulation status was evaluated with TEG and it was decided how to apply blood and blood product use. Blood and blood product use was applied to 100 patients in the control group based on clinical experience and foresight. The total amount of blood and blood product used, fluid balance, need for inotropics, mechanical ventilator time, complications, duration of intensive care and discharge times were recorded. Results: Use of Fresh Frozen Plasma (FFP) at the after CPB in the TEG group was statistically significantly lower than that of the control group FFP (p<0.05). Postoperative FFP and postoperative platelet use in the study group were statistically significantly lower than in the postoperative FFP and postoperative platelet values of the control group (p <0.05). Conclusion: The use of thromboelastography is a very useful monitoring in terms of reducing FFP use after CPB and reducing FFP and platelet usage in the postoperative period. In this way, the unnecessary use of blood and blood products can be prevented.

scholarly journals Influence of biomarkers level during follow-up when operating under cardiopulmonary bypass

2015 ◽  
Vol 18 (3) ◽  
pp. 39
Author(s):  
Yu. I. Petrishchev ◽  
A. L. Levit ◽  
I. N. Leyderman
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Plasma Levels ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cardiac Surgeons ◽  
The Given ◽  
The Relationship

Systemic inflammatory response was first determined in 1980 and cardiac surgeons turned to it in 1996. At present, there are a lot of publications on this issue, however, the extent of operation and duration of CPB are considered in clinical practice as crucial indicators of severity of patient's condition following cardiac surgery. In our study we tried to look at this problem from a different perspective and draw a parallel between the severity of patient's condition resulting from operational trauma and CPB. We included 48 patients who under-went cardiac surgery under CPB. Plasma levels of procalcitonin (PCT), lactate and interleukin-6 were investigated before the operation, after CPB and at 24 hours. Also revealed was the relationship between the plasma levels of IL-6, lactate and PCT (r = 0.53; p = 0.000 in both cases). The level of PCT at the 3rd stage was found to relate to the duration of CPB (r = 0.4; p = 0.005), ALV (r = 0.44; p = 0.001) and length of stay at ICU (r = 0.53; p = 0.000). We didn't manage to find any relationship between the length of stay at ICU and the duration of CPB. Correlation between the PCT plasma level and the duration of intensive care indicates the importance of dynamics of the given biomarker for early prediction of follow-up course after open-heart surgery.

Abstract 266: Incidence, Predictors and Outcomes of Permanent Pacemaker Implantation Among Patients With Bradyarrhythmias Following Cardiac Surgery: Insights From the National Inpatient Sample Database

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Karol Quelal ◽  
Olakanmi Olagoke ◽  
Jose Baez
Keyword(s):  
Cardiac Surgery ◽  
Valve Replacement ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Hospital Death ◽  
National Inpatient Sample ◽  
Permanent Pacemaker Implantation

Introduction: Significant atrioventricular blocks and bradyarrhythmias are known complications of open-heart surgery. These are frequently transient, however, some patients go on to need a permanent pacemaker (PP). We sought to describe the incidence, predictors, and outcomes of PP implantation among patients admitted for cardiac surgery who develop bradyarrhythmias. Methods: We queried the National Inpatient Sample (NIS) database from 2010 to 2014 for adults admitted for surgical valve replacement, valvuloplasty or coronary artery bypass grafting (CABG) who had bradyarrhythmias during the admission using the appropriate ICD codes. We identified patients who had permanent pacemaker implantation documented during the admission. Categorical and continuous variables were compared using the chi-square and student's t-test. Predictors of PP implantation and in-hospital mortality were evaluated by logistic regression. Results: Of the 1402930 patients who underwent cardiac surgery, 94748 patients had bradyarrhythmias defined as sinoatrial node dysfunction (SND) and/or atrioventricular block (AVB) during hospitalization. The primary procedure was identified as valve replacement in 50.3% (47615 of 94748), CABG in 29.9% (27622 of 94748) and valvuloplasty in 8.7% (8248 of 94748). SND was found in 29.9% (28372 of 94748) and AVB in 76% (72017 of 94748). Permanent pacemaker implantation was done in 39.3% (37246 of 94748). Valve replacement was the most common surgery associated with PP implantation [58% (21682 of 37246) compared to 21.5% in CABG (8007 of 37246) and 7.7% in valvuloplasty (2882 of 37246), p < 0.001). Female sex aOR 1.36 (95% CI 1.31 - 1.40), young age 18 - 44 years aOR 1.36 (95% CI 1.24 - 1.49), Asiatic and Hispanic origin aOR 1.36 (95% CI 1.23 - 1.51), aOR 1.25 (95% CI 1.17 - 1.34) respectively, diabetes mellitus with chronic complications aOR 1.16 (95% CI 1.09 - 1.24), drug abuse aOR 1.38 (95% CI 1.21 - 1.55) were associated with higher odds of pacemaker implantation. African American origin aOR 0.79 (95CI 0.74 - 0.85), AIDS aOR 0.33 (95% CI 0.17 - 0.67), south hospital region aOR 0.89 (95% CI 0.85 - 0.93), no-charge admissions aOR 0.66 (95% CI 0.49 - 0.89) were associated with a lower odds of PPM implantation. Death during hospitalization was found in 3% of the patients. After multivariable regression, PP implantation was associated with a lower likelihood of in-hospital death aOR 0.45 (95% CI 0.41 - 0.50). Conclusion: Approximately one-third of the patients hospitalized for cardiac surgery related to AVB and/or SND were implanted a permanent pacemaker. Factors like age, sex, race and comorbidities determine the likelihood of this procedure that has a significant impact on mortality. Having a better insight into these predictors would allow a better triage of patients who would benefit from its implantation.

Ultrafiltration in Pediatric Cardiac Surgery Review

2019 ◽  
Vol 10 (6) ◽  
pp. 778-788 ◽  
Author(s):  
Joel Bierer ◽  
Roger Stanzel ◽  
Mark Henderson ◽  
Suvro Sett ◽  
David Horne
Keyword(s):  
Cardiac Surgery ◽  
Clinical Outcomes ◽  
Heart Surgery ◽  
Fluid Overload ◽  
Meta Analysis ◽  
Open Heart Surgery ◽  
Pediatric Cardiac Surgery ◽  
Significant Heterogeneity ◽  
Study Protocols ◽  
The Impact

Introduction: The use of cardiopulmonary bypass in pediatric cardiac surgery is associated with significant inflammation, fluid overload, and end-organ dysfunction yielding morbidity and mortality. For decades, various intraoperative ultrafiltration techniques such as conventional ultrafiltration, modified ultrafiltration (MUF), zero-balance ultrafiltration (ZBUF), and combination techniques (ZBUF-MUF) have been used to mitigate these toxicities and promote improved postoperative outcomes. However, there is currently no consensus on the ultrafiltration technique or strategy that yields the most benefit for infants and children undergoing open heart surgery. Methods: A librarian-conducted PubMed literature search from 1990 to 2018 yielded 90 clinical studies or publications on the various forms of ultrafiltration and the impact on physiologic markers and clinical outcomes. All publications were reviewed, summarized, and conclusions synthesized. The data sets were not combined for systematic or meta-analysis due to significant heterogeneity in study protocols and patient populations. Results: Modified ultrafiltration significantly promotes improved myocardial function, reduction in fluid overload, and reduced bleeding and transfusion complications. Furthermore, ZBUF has shown a consistent reduction in inflammatory cytokines and improved pulmonary function and compliance. There is conflicting evidence that MUF, ZBUF, and ZBUF-MUF culminate in reduced ventilation time and intensive care unit stay. Conclusion: Various modes of ultrafiltration have been shown to be associated with improved physiologic function or clinical outcomes in pediatric cardiac surgery. There are some inconsistent trial results that can be explained by heterogeneity in ultrafiltration, clinical staff preferences, and institution protocols. Ultrafiltration has some essential benefit as it is ubiquitously used at pediatric heart centers; however, the optimal protocol could be yet identified.

scholarly journals Comparison of growth and feeding method in infants with and without genetic abnormalities after neonatal cardiac surgery

2020 ◽  
Vol 30 (12) ◽  
pp. 1826-1832
Author(s):  
Alyson R. Pierick ◽  
Trudy A. Pierick ◽  
Benjamin E. Reinking
Keyword(s):  
Cardiac Surgery ◽  
Genetic Testing ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Growth Delay ◽  
Feeding Method ◽  
Genetic Abnormalities ◽  
Neonatal Cardiac Surgery ◽  
The Impact

AbstractIntroduction:Congenital heart disease (CHD) is multifactorial in origin, resulting from an interaction between environmental and genetic factors. Multifactorial growth delay is common in infants with CHD. The impact of a genetic abnormality and CHD on the growth of an infant is lacking in the literature. The aim of this study is to compare the growth and method of feeding following neonatal cardiac surgery in infants with normal versus abnormal genetic testing.Methods:A retrospective chart review of neonates who underwent a Risk Adjustment in Congenital Heart Surgery IV–VI procedure between 1 January, 2006 and 22 September, 2016 was performed at our institution. Weight, length, head circumference measurements, and feeding method were collected at birth, time of neonatal surgery, and monthly up to 6 months of age.Results:A total of 53 infants met inclusion criteria, of which 22 had abnormal genetic testing. Approximately 90% of infants were discharged following neonatal cardiac surgery with supplemental tube feeds. At each monthly follow-up visit, more infants were exclusively fed orally: 80% of infants with normal genetics at 5 months post-operative follow-up versus 60% of infants with abnormal genetic testing, although statistically insignificant. Growth was not different among the two groups.Conclusions:Infants with critical CHD with or without genetic abnormalities are at risk for growth delays and many need supplemental tube feeds post-operatively and throughout follow-up. Infants with genetic abnormalities are slower to achieve oral feeds and more likely to require tube feedings. It is important to have a systematic protocol for managing these high-risk infants.

scholarly journals Hyperinsulinemic-normoglycemic clamp administered together with amino acids induces anabolism after cardiac surgery

2016 ◽  
Vol 311 (6) ◽  
pp. R1085-R1092 ◽  
Author(s):  
Takumi Codère-Maruyama ◽  
Thomas Schricker ◽  
Dominique Shum-Tim ◽  
Linda Wykes ◽  
Evan Nitschmann ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Whole Body ◽  
High Dose ◽  
Protein Balance ◽  
Body Protein

Cardiac surgery triggers an inflammatory stress response, leading to protein catabolism, a process that even high-dose insulin therapy alone cannot reverse. To determine whether hyperinsulinemic-normoglycemic clamp and perioperative amino acid (AA) supplementation improves whole body protein balance, 20 patients scheduled for elective coronary artery bypass grafting surgery were randomly assigned to have intra- and postoperative hyperinsulinemic-normoglycemic clamp, with or without intravenous AA supplementation. Primed continuous infusions of [6,6-2H2]glucose and l-[1-13C]leucine were used to quantify whole body protein and glucose metabolism before and after surgery. Adipose tissue and serum cytokines were also analyzed to measure their responsiveness to the anabolic effect of AA administration. During hyperinsulinemic-normoglycemic clamp, AA supplementation successfully stimulated whole body protein synthesis, resulting in a positive whole body protein balance after surgery (insulin: −13.6 ± 4.5 vs. insulin + AA: 2.1 ± 5.4 μmol·kg−1·h−1, P < 0.001). Endogenous glucose production was equally suppressed in both groups (insulin: 0.0 ± 3.8 vs. insulin + AA 1.6 ± 1.6 μmol·kg−1·min−1, P = 0.230). AA supplementation led to significant changes in serum and tissue IL-6 (insulin: 246.6 ± 111.2 vs. insulin + AA: 124.5 ± 79.3 pg/ml, P = 0.011). In conclusion, hyperinsulinemic-normoglycemic clamp technique, together with AA supplementation, can induce an anabolic state after open-heart surgery, as quantified by a positive whole body protein balance.

Evaluation of a “tummy time” intervention to improve motor skills in infants after cardiac surgery

2021 ◽  
pp. 1-6
Author(s):  
Karen Uzark ◽  
Cynthia Smith ◽  
Sunkyung Yu ◽  
Ray Lowery ◽  
Christopher Tapley ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Motor Skill ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Standard Of Care ◽  
Motor Impairments ◽  
Parental Compliance ◽  
Increased Risk ◽  
Tummy Time

Abstract Background: Infants who require open heart surgery are at increased risk for developmental delays including gross motor impairments which may have implications for later adaptive skills and cognitive performance. We sought to evaluate the feasibility and efficacy of a tummy time intervention to improve motor skill development in infants after cardiac surgery. Methods: Infants <4 months of age who underwent cardiac surgery were randomly assigned to tummy time with or without outpatient reinforcement or standard of care prior to hospital discharge. The Alberta Infant Motor Scale (AIMS) was administered to each infant prior to and 3 months after discharge. Groups were compared, and the association between parent-reported tummy time at home and change in motor scores at follow-up was examined. Results: Parents of infants (n = 64) who had cardiac surgery at a median age of 5 days were randomly assigned to tummy time instruction (n = 20), tummy time + outpatient reinforcement (n = 21) or standard of care (n = 23). Forty-nine (77%) returned for follow-up. At follow-up, reported daily tummy time was not significantly different between groups (p = 0.17). Fifteen infants had <15 minutes of tummy time daily. Infants who received >15 minutes of tummy time daily had a significantly greater improvement in motor scores than infants with <15 minutes of tummy time daily (p = 0.01). Conclusion: In infants following cardiac surgery, <15 minutes of tummy time daily is associated with increased motor skill impairment. Further research is needed to elucidate the best strategies to optimise parental compliance with tummy time recommendations.

scholarly journals Effect of Alpha-Lipoic Acid on Atrial Fibrillation after Open Heart Surgery

2020 ◽  
Author(s):  
Wael Elfeky ◽  
Dalia R El-Afify
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Lipoic Acid ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Group Versus ◽  
Control Group ◽  
Alpha Lipoic Acid ◽  
Reactive Protein

Background: Postoperative atrial fibrillation (POAF) is associated with increased morbidity and mortality, and an inflammatory process is involved in its pathogenesis. We aimed to study the possible effect of alpha-lipoic acid (ALA) as an antioxidant on atrial fibrillation after cardiac surgery. Methods: The study included ninety patients who underwent cardiac surgery, either valvular or coronary artery bypass grafting using cardiopulmonary bypass, and were randomized into two groups: Control and ALA groups. Blood samples were obtained to measure preoperative and postoperative levels of malondialdehyde (MDA), glutathione, C-reactive protein (CRP) and interleukin-6 (IL-6). The patients were monitored for the occurrence of atrial fibrillation until the day of discharge. Results: POAF occurred in 33% in the control group versus 11% in the ALA group (p=0.011).  When compared to the control group, ALA significantly decreased the postoperative levels of MDA (4.78±0.91 vs. 5.36±1.03 nmol/ml; p= 0.006) CRP (19.44±3.14 vs. 26.56±6.29 mg/dl; p <0.001) and IL-6 (22.25±2.2 vs. 25.37±2.5 pg/ml; p< 0.001) while glutathione level increased significantly in patients who received ALA (26.4±4.59 vs. 23.44±5.11 mg/l; p= 0.005). Conclusion: ALA may help in the prevention of atrial fibrillation following cardiac surgery through exerting antioxidant and anti-inflammatory effects.

scholarly journals Effects of Obesity on Mortality and Morbidity in High-Risk Open Heart Surgery Patients

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hulya Yilmaz Ak ◽  
◽  
Yasemin Ozsahin ◽  
Mehmet Ali Yesiltas ◽  
Ismail Haberal ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Obese Group ◽  
Open Heart ◽  
Mortality And Morbidity ◽  
High Risk Patients ◽  
Risk Patients

Background: The results of studies on the effect of obesity on mortality and morbidity in cardiac surgery are limited and contradictory. Today, the population of patients referred for open heart surgery is changing, and high-risk patients now represent a significant proportion of surgical candidates. In this study, the effect of obesity on mortality and morbidity in high risk patients in cardiac surgery was investigated retrospectively. Methods: This study was carried out by retrospectively evaluating the data of patients who had undergone adult Open Heart Surgery (OHS) in a university hospital operating room in the last 5 years (2015-2020). A total of 924 patients were examined in the study. The current online version of EuroSCORE (www.euroscore.org) was used and was calculated separately for all patients. The information in the hospital data system, preoperative evaluation forms, anesthesia follow-up slips, perfusion cards and intensive care, nurse follow-up forms of the patients (n = 95) calculated as EuroSCORE ≥ 6 were examined. The patients were divided into two groups as obese (body mass index (BMI) ≥ 30kg / m²) and non-obese (BMI <30kg / m²). Results: In the preoperative data, patients with diabetes mellitus in the obese group were statistically higher than the non-obese group (p=0.018). Mortality rate did not differ according to the groups (p> 0.05). Conclusion: In this study, no additional negative risk of obesity, which is considered to be an important risk factor for heart diseases, on cardiac surgery was determined.

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