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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2018 Feb 08

DOI: 10.23736/S0021-9509.18.10123-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

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: 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 Centre study in the University Medical Centre 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 surgery - Aortic cross clamp time - Cardiopulmonary bypass time - Postoperative complications

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Publication History

Article first published online: February 08, 2018
Manuscript accepted: January 30, 2018
Manuscript revised: November 15, 2017
Manuscript received: July 20, 2017

Per citare questo articolo

Verheijen LP, van Zaane B, van Aarnhem EE, Peelen LM, van Klei WA. The association between aortic cross clamp time and postoperative morbidity and mortality in mitral valve repair: a retrospective cohort study. J Cardiovasc Surg 2018 Feb 08. DOI: 10.23736/S0021-9509.18.10123-6

Corresponding author e-mail

l.p.j.verheijen-2@umcutrecht.nl