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The association between preoperative blood calcium and postoperative blood loss in patients undergoing heart valve

Mingke Li1, Yawei Dai1, Shuai Hu1

  • 1Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Perfusion
|November 17, 2022
PubMed

Insights

Preoperative hypocalcemia (low blood calcium) significantly increases the risk of bleeding after heart valve surgery. Promptly correcting low calcium levels before operation may help control postoperative blood loss.

Area of Science:

  • Cardiology
  • Surgical Hemorrhage
  • Calcium Metabolism

Background:

  • Bleeding following heart valve surgery presents a significant clinical challenge.
  • Hypocalcemia is linked to bleeding in other conditions, but its role in heart valve surgery is unclear.

Purpose of the Study:

  • To determine the association between preoperative blood calcium levels and perioperative hemorrhage in patients undergoing heart valve replacement therapy.

Main Methods:

  • Patients were categorized into hypocalcemia and normocalcemia groups based on preoperative blood calcium levels.
  • Postoperative bleeding, blood product usage, and complications were monitored.
  • Multivariable logistic regression models assessed the link between calcium levels and major bleeding.

Main Results:

  • The hypocalcemia group exhibited significantly greater bleeding in the first 12 hours post-surgery (338 mL vs. 232 mL) and higher overall chest tube output (950 mL vs. 738 mL).
  • Major bleeding incidence was substantially higher in the hypocalcemia group (65.91%) compared to the normocalcemia group (18.97%).
  • Adjusted analysis revealed a tenfold increased odds of major bleeding in the hypocalcemia group (OR 10.01).

Conclusions:

  • Preoperative blood calcium concentrations are associated with postoperative blood loss in heart valve surgery patients.
  • Hypocalcemia before surgery may elevate the risk of significant postoperative bleeding.
  • Intervention for hypocalcemia in valvular heart disease patients prior to surgery could improve postoperative bleeding control.
Abstract

Keywords:
Cardiac valve replacementhypocalcemiamajor bleedingnormocalcemiapostoperative bleeding

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