The Impact of Hyponatremia in Aortic Valve Surgery Using Histidine–Tryptophan–Ketoglutarate Cardioplegia
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30 set 2024
INFORMAZIONI SU QUESTO ARTICOLO
Categoria dell'articolo: Original Research
Pubblicato online: 30 set 2024
Pagine: 95 - 101
Ricevuto: 01 ago 2024
Accettato: 21 ago 2024
DOI: https://doi.org/10.2478/jce-2024-0015
Parole chiave
© 2024 Claudiu Ghiragosian et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
FIGURE 1.
FIGURE 2.
Baseline characteristics of patients according to preoperative Na levels
| Age (n, %) | |||
| <60 years | 31 (26.1) | 54 (29.5) | 0.002 |
| 61–70 years | 48 (40.3) | 91 (49.7) | 0.056 |
| >70 years | 40 (33.6) | 38 (20.8) | 0.545 |
| Female (n, %) | 38 (31.9) | 72 (39.3) | 0.924 |
| Comorbidities (n, %) | |||
| Dyslipidemia | 43 (36.1) | 76 (41.5) | 0.258 |
| Obesity | 21 (17.6) | 39 (21.3) | 0.830 |
| Diabetes mellitus | 23 (19.3) | 46 (25.1) | 0.430 |
| Arterial hypertension | 78 (65.5) | 140 (76.5) | 0.968 |
| Preoperative echocardiography | |||
| LVEF, % (median, 95% CI) | 55.0 (50.0–55.0) | 55.0 (50.0–55.0) | 0.841 |
| Ao max gradient, mmHg (median, 95% CI) | 80.0 (75.0–84.0) | 80.0 (77.0–85.0) | 0.389 |
| Ao medium gradient, mmHg (median, 95% CI) | 48.0 (45.3–52.7) | 49.0 (46.0–53.0) | 0.564 |
| LV diastolic diameter, mm (median, 95% CI) | 53.0 (52.0–55.0) | 52.0 (50.0–54.0) | 0.099 |
| Preoperative blood levels | |||
| pH (median, 95% CI) | 7.45 (7.42–7.47) | 7.42 (7.41–7.43) | 0.022 |
| Lactate, mmol/l (median, 95% CI) | 1.4 (1.4–1.5) | 1.3 (1.2–1.4) | 0.015 |
| Surgery duration, min (mean ± s.d.) | 337.5 ± 81.4 | 402.1 ± 264.1 | <0.001 |
| Bypass duration, min (mean ± s.d.) | 122.5 ± 53.1 | 93.8 ± 34.1 | <0.001 |
| Aortic clamp duration, min (mean ± s.d.) | 81.3 ± 34.4 | 66.7 ± 23.8 | <0.001 |
| Postoperative orotracheal intubation, h (mean ± s.d.) | 13.7 ± 15.9 | 9.9 ± 10.0 | <0.001 |
| Postoperative inotropic/vasopressor support, days (mean ± s.d.) | 1.8 ± 1.9 | 1.6 ± 2.0 | 0.018 |
| Postoperative echocardiography | |||
| LVEF, % (median, 95% CI) | 50.0 (45.0–55.0) | 50.0 (45.0–55.0) | 0.253 |
| Ao max gradient, mmHg (median, 95% CI) | 22.0 (20.0–24.0) | 21.0 (18.0–23.0) | 0.804 |
| Ao medium gradient, mmHg (mean ± s.d.) | 8.0 (7.0–8.0) | 7.0 (6.8–8.0) | 0.225 |
| Postoperative blood levels | |||
| Na, mmol/l (median, 95% CI) | 134.8 (133.6–135.5) | 134.9 (134.7–135.6) | 0.253 |
| pH (median, 95% CI) | 7.42 (7.39–7.45) | 7.45 (7.42–7.47) | 0.197 |
| Lactate, mmol/l (median, 95% CI) | 1.4 (1.3–1.7) | 1.5 (1.4–1.7) | 0.847 |
Postoperative outcomes
| Surgical reintervention (n, %) | 10 (8.4) | 5 (2.7) | 3.65 (1.18–11.34) | 0.025 |
| New onset of AFib (n, %) | 8 (6.7) | 19 (10.4) | 0.73 (0.30–1.77) | 0.485 |
| Sustained VT/VF (n, %) | 2 (1.7) | 3 (1.6) | 0.39 (0.07–2.01) | 0.259 |
| Neurological impairment (n, %) | 1 (0.8) | 3 (1.6) | 0.35 (0.03–3.77) | 0.384 |
| 7-day mortality (n, %) | 9 (7.6) | 2 (1.1) | 7.40 ((1.57–34.90) | 0.011 |
| 30-day mortality (n, %) | 13 (10.9) | 3 (1.6) | 7.36 (2.05–26.42) | 0.002 |