Incidence of cardiac events in on-pump elective surgical interventions on the aorta and heart valves

Abstract

Aim. To determine the incidence and predictors of cardiovascular events in onpump cardiac operations in modern practice.Material and methods. The study included 200 patients who underwent various elective cardiac surgical interventions. Cardiovascular events (CVEs) were determined within 30 days from the operation, according to medical records and autopsy protocols. We identified major CVEs (cardiovascular death, stroke, myocardial infarction) and minor CVEs (angina pectoris, significant ventricular arrhythmias, atrial fibrillation or flutter episodes, AV conduction disorders, etc.). A comprehensive preoperative examination was performed, including an extended echocardiography protocol and coronary angiography.Results. In 101 patients (50,05%), various CVEs were identified: 4,0% had major CVEs and 46,05% had minor CVEs and various non-cardiac complications, while perioperative mortality was 2,0%. Most ischemic CVEs, as well as most intracardiac conduction disorders, were registered during the first 3 days after surgery. In contrast, episodes of atrial fibrillation/flutter occurred 2-7 days after the intervention. There were following preoperative examination parameters with the highest prognostic value: history of heart failure, age >65 years, history of myocardial infarction, occlusion of at least one coronary artery, and diabetes.Conclusion. The data obtained indicate the high efficiency of current surgical and anesthetic technologies, which lead to relatively low risk of severe and fatal events. The parameters of the preoperative examination, which determine the increased risk of intervention, are highlighted.