Zvara David A, Bryant Andrew, Veal Mary, Dull Bradley, Hillegass Gabe, McCoy Thomas P, Kon Neal D
Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1009, USA.
J Cardiothorac Vasc Anesth. 2006 Apr;20(2):149-55. doi: 10.1053/j.jvca.2005.10.013. Epub 2006 Feb 14.
This study examined if the degree of atherosclerosis in the descending aorta is an independent predictor of poor in-hospital outcome for patients presenting for surgery involving cardiopulmonary bypass.
The degree of atherosclerosis of the descending aorta was retrospectively reviewed in patients presenting for surgical procedures involving cardiopulmonary bypass from January 1, 2000, to December 31, 2003. Preoperative risk factors and in-hospital postoperative outcome parameters were obtained.
University teaching hospital.
There were 310 consecutive patients enrolled in the study.
None.
Two hundred forty-seven patients had coronary artery bypass grafting with or without valvular surgery, and 63 patients had isolated valvular surgery. The degree of atherosclerosis was rated as normal in 86 (28%), mild in 106 (34%), moderate in 69 (22%), and severe in 49 (16%) patients. Adjusting only for the degree of atherosclerosis, the total intensive care unit (ICU) time and the number of deaths were significantly higher in those patients with severe disease. Multivariable models adjusting for patients' risk factors showed a significant influence of atherosclerosis on total ICU time but not on other outcomes. The strongest predictor of poor outcome was a history of previous stroke (cerebral vascular accident). Other significant factors predicting poor outcome included previous coronary artery bypass surgery, a history of congestive heart failure, a history of dialysis, advanced age, and female sex.
The degree of atherosclerosis in the descending aorta is not an independent predictor of poor in-hospital outcome after surgery involving cardiopulmonary bypass.
