Myocardial ischaemic time and its relation with left ventricular ejection fraction after single valve replacement
I N Izham1, D M Zamrin, O S M Joanna
1Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Insights
Myocardial ischemic time did not significantly impact left ventricular ejection fraction (LVEF) changes after valve replacement surgery. Improvements in LVEF were observed up to six months post-operation, regardless of ischemic duration.
Area of Science:
- Cardiovascular Surgery
- Cardiac Anesthesia
- Echocardiography
Background:
- Left ventricular ejection fraction (LVEF) is a key indicator of cardiac function post-valve replacement surgery.
- Myocardial ischemic time is a critical factor influencing cardiac recovery after cardiopulmonary bypass.
- Understanding the relationship between ischemic time and LVEF is crucial for optimizing surgical outcomes.
Purpose of the Study:
- To investigate the correlation between myocardial ischemic time and changes in LVEF up to six months after valve replacement surgery.
- To assess the impact of aortic cross-clamping duration on postoperative LVEF.
Main Methods:
- Single-center observational study including 44 patients undergoing valve replacement.
- Serial echocardiographic examinations at baseline, 2 weeks, and 6 months post-operation.
- Analysis of myocardial ischemic time (aortic cross-clamping) and its association with LVEF changes.
Main Results:
- Significant improvements in LVEF were observed at six months post-surgery (59±10% to 63±10%).
- Left ventricular dimensions (LVEDD and LVESD) showed significant reductions at six months.
- No significant correlation was found between aortic cross-clamping time and LVEF changes at early or late postoperative periods.
Conclusions:
- Postoperative LVEF improves significantly at six months following valve replacement surgery.
- The duration of myocardial ischemic time does not appear to significantly affect LVEF changes in the early and late postoperative periods.
Background And Aims:
The effect of the duration of ischaemic myocardial time to left ventricular ejection fraction (LVEF) after valve replacement surgery has been attributed. This study aims to look at the correlation between myocardial ischaemic time and changes LVEF post valve replacement surgery up to 6 months period.
Patients And Methods:
This is a single centre observational study. Forty-four patients were included in the study from total of 82 patients. Serial echocardiographic examinations were taken at baseline, early postoperative (2 weeks) and late (6 months) post operative.
Results:
Seventeen males and 27 females, mean age of 46±14 years were studied. Mean NYHA Class was 1.7±0.8. Morbidity recorded in 14 patients (31.8). There were three mortalities (6.8%). Thirty eight (86.4%) patients had mitral valve replacement and 6 (13.6%) patients had aortic valve replacement. Mean cardiopulmonary bypass time (CPB) was 108±25 minutes. Mean time for aortic cross clamping time was 84±20 minutes. Left ventricular end diastolic diameters (LVEDD), left ventricular ejection systolic diameter (LVESD) were significantly reduced from 5.2±0.7 cm to 4.8±0.6 cm and from 3.5±0.7 cm to 3.1±0.5 cm at 6 months respectively. LVEF showed significant improvements from 59±10 cm to 63±10 cm at 6 months. There was no significant correlation between aortic cross clamping time with changes in LVEF at early postoperative (p=0.674) and late postoperative (p=0.798).
Conclusion:
This study showed that improvements in LVEF were seen at 6 months post operatively. We found that the duration of myocardial ischaemic time did not significantly affect post operative LVEF changes.
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