Zheng Shuai, Wang Jiangang, Zhang Haibo, Wang Shengyu, Meng Xu
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Front Cardiovasc Med. 2024 Feb 16;11:1360763. doi: 10.3389/fcvm.2024.1360763. eCollection 2024.
The clinical prognosis of mitral valve surgery at morning, afternoon, and evening is not yet clear. The aim of the study is to investigate the impact of different time periods of surgery in the morning, afternoon and evening on the short-term and long-term results of mitral valve surgery.
From January 2018 to December 2020, 947 patients with mitral valve surgery in our department were selected. These patients were divided into 3 groups according to the starting time of surgery. Morning group (operation start time 8:00-10:30, = 231), afternoon group (operation start time 12:00-14:30, = 543), and evening group (operation start time 17:30-20:00, = 173). The short-term and long-term results of the three groups were compared.
There were no significant difference in the long-term mortality, long-term risk of stroke and reoperation. And there were no significant difference in in-hospital outcomes, including mortality, stroke, cardiopulmonary bypass time, aortic cross clamp time, mitral valve repair convert to mitral valve replacement, number of aortic cross clamp ≥2 times, unplanned secondary surgery during hospitalization (including thoracotomy hemostasis, thoracotomy exploration, redo mitral valve surgery, and debridement), intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, mechanical ventilation time, and intensive care unit length of stay.
There is no significant difference in the risk of short-term and long-term survival and adverse events after mitral valve surgery at different time periods in the morning, afternoon, and evening. Mitral valve surgery at night is safe.
二尖瓣手术在上午、下午和晚上进行时的临床预后尚不清楚。本研究旨在探讨上午、下午和晚上不同手术时间段对二尖瓣手术短期和长期结果的影响。
选取2018年1月至2020年12月在我科行二尖瓣手术的947例患者。根据手术开始时间将这些患者分为3组。上午组（手术开始时间8:00 - 10:30，n = 231），下午组（手术开始时间12:00 - 14:30，n = 543），晚上组（手术开始时间17:30 - 20:00，n = 173）。比较三组的短期和长期结果。
长期死亡率、长期卒中风险和再次手术率无显著差异。住院期间的结局，包括死亡率、卒中、体外循环时间、主动脉阻断时间、二尖瓣修复转为二尖瓣置换、主动脉阻断≥2次的次数、住院期间非计划二次手术（包括开胸止血、开胸探查、二尖瓣再次手术和清创）、主动脉内球囊反搏、体外膜肺氧合、持续肾脏替代治疗、机械通气时间和重症监护病房住院时间，均无显著差异。
二尖瓣手术在上午、下午和晚上不同时间段进行时，短期和长期生存风险及不良事件无显著差异。夜间进行二尖瓣手术是安全的。
