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[Predicting postoperative acute heart failure after surgical treatment of patients with post-infarction heart
Insights
Identifying risk factors for acute cardiac insufficiency after heart aneurysm surgery is crucial. Low ejection fraction, stroke index, and left coronary artery disease indicate high risk, aiding in patient stratification and improved outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Diagnostics
Context:
- Post-surgery complications following treatment for chronic post-infarction aneurysm of the heart.
- Analysis of 122 patients undergoing surgical intervention.
- Focus on identifying predictors for acute cardiac insufficiency.
Purpose:
- To determine clinico-hemodynamic and angiocardiographic risk factors for postoperative acute cardiac insufficiency.
- To establish objective criteria for assessing patient risk.
- To enable quantitative risk appraisal and patient classification.
Summary:
- Key risk factors identified include ejection fraction <38%, stroke index <38 ml/m2, and left main coronary artery disease.
- Additional unfavorable indicators include cardiac asthma, multiple prior infarctions, poor left ventricular wall perfusion, low total ejection fraction (<25%), low cardiac index (<2.5 L/min/m2), and elevated end-diastolic pressure (>24 mm Hg).
- A risk index scoring system was developed for quantitative assessment and objective prognostication.
Impact:
- Facilitates objective risk stratification of patients undergoing surgery for post-infarction heart aneurysms.
- Enables proactive management strategies to mitigate the risk of acute cardiac insufficiency.
- Improves clinical decision-making and patient outcomes in complex cardiac surgery.
Abstract:
The clinoco-hemodynamic and angiocardiographic indices were analysed in 122 patients to determine the risk factors of postoperative development of acute cardiac insufficiency after surgery for chronic postinfarction aneurysm of the heart. The risk of the development of the complication was high in patients with the ejection fraction of the contracting part less than 38%, the stoke index below 38 ml/m2, and affection of the trunk of the left coronary artery. Other prognostically unfavourable indices are a clinical picture of cardiac asthma, a history of more than two infarctions, poor blood supply to the lateral wall of the left ventricle, total ejection fraction of less than 25%, cardiac index below 2.5 l/min/m2, and end diastolic pressure of more than 24 mm Hg. Appraisal of the risk index in marks made it possible to determine quantitatively the significance of each prognostic index, classify the patients according to the degree of the initial severity, and prognosticate the development of acute cardiac insufficiency objectively.