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 ◽  
...  

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.

Cardiology ◽  
1996 ◽  
Vol 87 (6) ◽  
pp. 509-515 ◽  
Author(s):  
Dimitri Novitzky ◽  
Hector Fontanet ◽  
Michael Snyder ◽  
Nicholas Coblio ◽  
Daniel Smith ◽  
...  

2017 ◽  
Vol 20 (3) ◽  
pp. 287 ◽  
Author(s):  
Marc Licker ◽  
Christoph Ellenberger ◽  
Tornike Sologashvili ◽  
Mustafa Cikirikcioglu ◽  
Gabriel Verdon ◽  
...  

2015 ◽  
Vol 18 (3) ◽  
pp. 39
Author(s):  
Yu. I. Petrishchev ◽  
A. L. Levit ◽  
I. N. Leyderman

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.


2015 ◽  
Vol 17 (6) ◽  
pp. 277 ◽  
Author(s):  
Hanif Tabesh ◽  
Hossein Ahmadi Tafti ◽  
Sara Ameri ◽  
Arash Jalali ◽  
Narges Kashanivahid

<p><b>Background:</b> Conventionally, there is controversy over subjecting high-risk patients to cardiac operations, due to major postoperative complications. Higher survival rates and less morbidity as well as better quality of life can be good predictors of the outcome of surgery. This study evaluates the quality of life before and 12 months after cardiac operations on high-risk patients.</p><p><b>Methods:</b> In this study, the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was used to separate high-risk patients from others. The quality of life was assessed using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) before surgery and one year afterward. Based on SF-36, the score for each of the eight different dimensions of the quality of life was quantified; and, their differences between pre-surgery and post-follow up period were analyzed.</p><p><b>Results:</b> 126 high-risk patients were included in this study. The mean age of the patients was 64.29 � 12.35 years. The median of EuroSCORE II score in these cases was 6.83 (6.04-25.98). The results reveal that the majority of the quality of life dimensions, except mental health, improved significantly after the follow-up period.</p><p><b>Conclusion:</b> Cardiac surgery on high-risk patients can noticeably promote the different aspects of their quality of life; although, such improvements should be considered against surgical complications.</p>


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Garweg ◽  
S Iacopino ◽  
M.F El-Chami ◽  
C Veltmann ◽  
N Clementy ◽  
...  

Abstract Background The Micra transcatheter pacemaker has demonstrated a favorable safety and efficacy profile relative to transvenous pacing. Patients with a history of open heart surgery have a higher risk of complications with transvenous pacemakers during follow-up. The experience with leadless pacemakers among a large cohort of patients with a history of open heart surgery has not been reported. Objective To report outcomes in patients with a history of open heart surgery undergoing Micra implant. Methods Patients undergoing Micra implant from the Micra Transcatheter Pacing Post-Approval Registry (PAR) were included in the analysis. Baseline and procedural characteristics, major complications, and electrical performance were compared among patients with vs. without history of cardiac surgery. Results A total of 331 out of 1815 (18.2%) patients had a history of open heart surgery, underwent Micra implant, and were followed for 19.4±10.4 months. The mean age was 74.6±13.5 years, 40% were female. The most common cardiac surgery was aortic valve surgery (71%) followed by mitral valve surgery (39%). Patients with prior open-heart surgery were more likely to have contraindications to transvenous pacing, were more likely to be on oral anticoagulants, and had more co-morbidities including atrial fibrillation, heart failure, and coronary artery disease (all p&lt;0.005). Implantation was successful in 327 of 331 patients (98.8%) with a median procedure time of 29 minutes. Mean pacing capture thresholds (PCTs) at implant were 0.66±0.51V and remained stable through follow-up. There were 11 major complications in 10 cardiac surgery patients, with no device or procedure-related infections reported. The major complication rate was 3.1% (Figure) and was not significantly different than that of patients without a history of open heart surgery (HR: 0.85, P=0.640). There was 1 cardiac perforation (with no intervention required) in the open heart surgery group (0.3%) and there were 14 cardiac perforations (0.94%, P=0.332) in the non-open heart surgery group of which 10 required intervention. Conclusion The Micra transcatheter pacemaker can be safely implanted in patients with a history of open heart surgery, with a similar long-term safety profile to patients without a history of open heart surgery. Importantly, there were no device-related infections reported in either group. Risk of Major Complication Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Medtronic, Inc.


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