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Updated: Sep 4, 2025

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
04:48

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Published on: November 28, 2018

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A systemic congestive index (systemic pulse pressure to central venous pressure ratio) predicts adverse outcomes in

Ziyad O Knio1, Frances L Morales2, Kajal P Shah3

  • 1Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia, USA.

Journal of Cardiac Surgery
|July 17, 2022
PubMed

Insights

A low systemic pulse pressure (SPP) to central venous pressure (CVP) ratio (<7.6) indicates higher mortality risk in patients undergoing valvular heart surgery. This finding aids in preoperative risk stratification for better patient selection and prognosis.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Hemodynamics

Background:

  • Invasive hemodynamics offer detailed cardiac function assessment.
  • The systemic pulse pressure (SPP) to central venous pressure (CVP) ratio integrates right and left ventricular function.
  • This ratio may predict outcomes in valvular heart surgery.

Purpose of the Study:

  • To investigate the association between a low SPP/CVP ratio and mortality in valvular surgery patients.
  • To determine if the SPP/CVP ratio can serve as a predictor of adverse outcomes.

Main Methods:

  • Retrospective cohort study of 215 adult valvular surgery patients with preoperative right heart catheterization (2007-2016).
  • Analysis of associations between SPP/CVP ratio and mortality using univariate and multivariate methods.

Main Results:

  • A SPP/CVP ratio <7.6 was linked to increased mortality (RR 1.70, p=.019) and longer hospital stays.
  • The low SPP/CVP ratio independently predicted mortality (aOR 3.99, p=.008) after adjusting for multiple clinical factors.

Conclusions:

  • A low SPP/CVP ratio is associated with worse outcomes in valvular heart surgery.
  • This hemodynamic metric shows potential for preoperative risk stratification.
  • It may guide patient selection, prognosis, and surgical planning.
Abstract

Keywords:
heart failurehemodynamic monitoringperioperative mortalitypulmonary hypertensionvalvular surgeryventricular dysfunction

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