DYNAMICS OF SECONDARY PULMONARY HYPERTENSION AFTER CARDIAC SURGICAL PROCEDURES IN PATIENTS WITH LOW LEFT VENTRICULAR EJECTION FRACTION
Keywords:
left ventricular ejection fraction, pulmonary artery systolic pressure, pulmonary hypertension, cardiac surgeryAbstract
Сardiac surgical patients with low left ventricular ejection fraction (LVEF) have enhanced risk of perioperative complications. It is often accompanied with secondary pulmonary hypertension (PH), which heightens risk. With the purpose of evaluating PH changes after cardiac surgery and its effect on outcomes we carried out a retrospective observational study of all 65 patients with LVEF < 40%, operated on in our Centre during a 6 months period. All the patients had pulmonary hypertension (pulmonary artery systolic pressure (PASP) of (58.3±13.7) mmHg). 17 patients had isolated coronary artery bypass surgery, 48 of 65 patients (74%) had complex procedures, involving coronary arteries, heart valve and myocardium, with the use of cardiopulmonary bypass. 40 patients (61%) need complex postoperative management, and 7 patients (10.7%) had ICU length of stay more than 7 days. The mortality was 3%. Mean PASP decreased significantly up to (48.9± ±9.1) mmHg, р<0.05. Our results demonstrate that surgical repair for severe cardiac diseases in this category of patients is feasible, with acceptable complications and mortality rates, and decreases PH. Further studies for the estimation of the effect of such changes in pulmonary artery systolic pressure on outcomes are warranted.
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