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01-05-2012 | Original article | Uitgave 5/2012

Netherlands Heart Journal 5/2012

Preexisting heart failure is an underestimated risk factor in cardiac surgery

Tijdschrift:
Netherlands Heart Journal > Uitgave 5/2012
Auteurs:
K. A. Kortekaas, J. H. N. Lindeman, M. I. M. Versteegh, T. Stijnen, R. A. E. Dion, R. J. M. Klautz
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Electronic supplementary material

The online version of this article (doi:10.​1007/​s12471-012-0257-y) contains supplementary material, which is available to authorized users.

Abstract

Background

Heart failure is characterised as a strong risk factor for systemic failure after cardiac surgery. However, the impact has never been substantiated.

Methods

Patients with heart failure (n = 48) - scheduled for elective ventricular reconstruction or external constraint device-were compared with a one-to-one matched control group of patients without heart failure undergoing cardiac surgery between 2006 and 2009.

Results

As expected, patients with heart failure more frequently experienced complications definitely related to pump failure (p = 0.01). However, complications not related to their pump failure were also more often observed, such as prolonged mechanical ventilation, sepsis and vasoplegia (p = 0.01). Overall, organ dysfunction-circulatory, renal, and pulmonary failure-was often observed in heart failure patients, contributing to a prolonged stay in the intensive care unit (p < 0.001) as well as in hospital (p = 0.01).

Conclusion

The adverse postoperative course in patients with heart failure is not only directly related to circulatory failure, but merely reflects a systemic dysregulation. Our findings suggest that heart failure impacts outcome and should therefore be included in prevailing risk classification systems. Offensive perioperative treatment strategies, focused on the main complications in patients with heart failure, will lead to improved results after cardiac surgery.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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