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ORIGINAL ARTICLE  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2018 June;59(3):453-61

DOI: 10.23736/S0021-9509.18.10123-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

The association between aortic cross clamp time and postoperative morbidity and mortality in mitral valve repair: a retrospective cohort study

Lieke P. VERHEIJEN 1 , Bas van ZAANE 1, Egidius E. van AARNHEM 2, Linda M. PEELEN 1, 3, Wilton A. van KLEI 1

1 Department of Anesthesiology, Intensive Care and Emergency Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands; 2 Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands; 3 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands


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BACKGROUND: The aim of this study was to estimate the association between aortic cross clamp time and postoperative morbidity and mortality in patients undergoing mitral valve repair.
METHODS: A retrospective cohort study between 2006 and 2014 was performed as a single Center study in the University Medical Center Utrecht. In total 1007 patients who underwent mitral valve repair were included. The patients were divided into a group who underwent isolated mitral valve repair and a group who underwent mitral valve repair with concomitant intervention(s). The primary endpoint was a composite consisting of in-hospital mortality or postoperative major complications.
RESULTS: In the isolated mitral valve group (N.=405), patients were significantly younger, healthier and had fewer complications (9.9%). Patients with concomitant intervention(s) had a twofold higher rate of postoperative complications and mortality (18.1%). After adjustment for confounding there was no association between aortic cross clamp time and the primary endpoint in both the isolated mitral valve group (odds ratio 1.04; 95% CI: 0.98-1.11) and the group with concomitant interventions (odds ratio 1.02; 95% CI: 0.97-1.06).
CONCLUSIONS: In patients undergoing mitral valve repair surgery a longer aortic cross clamp time was not associated with postoperative complications and mortality. The higher postoperative morbidity and mortality in combined procedures appears to be due to a higher age, more comorbidities and an extra intervention rather than to the duration of aortic cross clamp time.


KEY WORDS: Mitral valve - Cardiopulmonary bypass - Postoperative complications

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