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Association between preoperative right heart catheterization parameters and outcomes in patients undergoing isolated

Irbaz Hameed1, Ralf Martz Sulague1, Eric S Li1

  • 1Division of Cardiac Surgery, Yale University School of Medicine, New Haven, CT, USA.

Interdisciplinary Cardiovascular and Thoracic Surgery
|September 13, 2024
PubMed

Insights

Preoperative right heart catheterization provides key prognostic data before coronary artery bypass grafting (CABG). Elevated central venous pressure predicts operative mortality, while cardiac index impacts ICU stay and inotropic support duration.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Critical Care Medicine

Background:

  • Right ventricular catheterization (RHC) can offer prognostic insights before coronary artery bypass grafting (CABG).
  • Preoperative assessment is crucial for optimizing outcomes in patients undergoing isolated CABG.

Purpose of the Study:

  • To evaluate the association between preoperative RHC parameters and patient outcomes after isolated CABG.
  • To determine the prognostic value of RHC in defining outcomes for CABG patients.

Main Methods:

  • Retrospective analysis of 2343 patients undergoing isolated CABG from 2013-2021.
  • Inclusion of 78 patients with preoperative RHC performed within 14 days of isolated CABG.
  • Multivariable regression analysis to identify significant associations between RHC parameters and outcomes.

Main Results:

  • Central venous pressure was significantly associated with operative mortality (OR 1.14, P=0.024).
  • Preoperative cardiac index was inversely associated with intensive care unit (ICU) length of stay (OR 0.72, P<0.001) and duration of inotropic support (OR 0.76, P<0.01).

Conclusions:

  • RHC parameters, including central venous pressure and cardiac index, are significant predictors of outcomes in patients undergoing isolated CABG.
  • Consider RHC for high-risk patients, especially those with left ventricular dysfunction, to guide preoperative optimization and intra-/postoperative decision-making.
  • RHC can inform decisions regarding alternative therapies like percutaneous coronary intervention, left ventricular assist device, or heart transplantation.

Keywords:
CABGPCIcoronary heart disease

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