Labaste François, Lavie-Badie Yoan, Bouchau Robin, Boyère Lucie, Sanchez-Verlaan Pascale, Gonzalez Hélène, Marcheix Bertrand, Botea Roxana, Vardon-Bounes Fanny, Minville Vincent
Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, Toulouse, France.
RESTAURE, UMR 1301 Inserm-5070 CNRS-Université de Toulouse, Toulouse, France.
Front Cardiovasc Med. 2024 Sep 20;11:1452820. doi: 10.3389/fcvm.2024.1452820. eCollection 2024.
Low cardiac output syndrome (LCOS) is a common complication in cardiac surgery, and we evaluated the incidence of its early occurrence after mitral and tricuspid combined cardiac surgery and its associated risk factors.
Retrospective, single institution study. We included 88 consecutive adult patients with severe mitral insufficiency scheduled for elective mitral and tricuspid valve replacement surgery between January 2015 and November 2018. The primary endpoint was the occurrence of LCOS, defined as the need for inotropic support or circulatory assistance after surgery. The secondary endpoint was mortality at 30 days.
LCOS occurred in 26 patients (29.5%) of the studied patients and its associated risk factors that appeared in the multivariate analysis were chronic kidney failure [adjusted odds ratio (OR) 3.1; 95% confidence interval (CI) 1.0-9.9, = 0.05], pre-operative left ventricular heart failure (OR 5.3; 95% CI 1.3-10.9, = 0.002), pre-operative right ventricular heart failure (OR 3.6; 95% CI 1.1-11.5, = 0.02), and mitral valve replacement (OR 3.9; 95% CI 1.2-12.6, = 0.03). LCOS affected the survival of patients (HR = 5.5; 95% CI 1.1-27.7 = 0.04).
LCOS is a frequent complication after mitral and tricuspid combined surgery and is associated with poor prognosis.
低心排血量综合征（LCOS）是心脏手术中常见的并发症，我们评估了二尖瓣和三尖瓣联合心脏手术后早期发生LCOS的发生率及其相关危险因素。
回顾性单机构研究。我们纳入了2015年1月至2018年11月期间连续88例计划进行择期二尖瓣和三尖瓣置换手术的重度二尖瓣关闭不全成年患者。主要终点是LCOS的发生，定义为术后需要使用血管活性药物支持或循环辅助。次要终点是30天死亡率。
在研究的患者中，26例（29.5%）发生了LCOS，多因素分析中出现的相关危险因素为慢性肾衰竭[调整优势比（OR）3.1；95%置信区间（CI）1.0 - 9.9，P = 0.05]、术前左心室心力衰竭（OR 5.3；95% CI 1.3 - 10.9，P = 0.002）、术前右心室心力衰竭（OR 3.6；95% CI 1.1 - 11.5，P = 0.02）以及二尖瓣置换（OR 3.9；9
