Abstract 11576: Association Between Pre-Operative Right Heart Catheterization Parameters and Outcomes in Isolated Coronary Artery Bypass Grafting

Abstract

Objective We evaluate the association between pre-operative right heart catheterization variables and outcomes in patients undergoing isolated coronary artery bypass grafting (CABG). Methods: All patients undergoing isolated CABG at our institution from 2013-2021 who also underwent pre-operative right heart catheterization <14 days prior to isolated CABG were retrospectively queried. The primary outcome was operative mortality. Secondary outcomes were post-operative myocardial infarction, stroke, need for dialysis, duration of intensive care unit (ICU) stay, and duration of inotropic support. Results: Seventy-eight patients were analyzed. The incidence of operative mortality was 8(10.3%). The incidence of the secondary outcomes was 7(9.0%) for myocardial infarction, 5(6.4%) for stroke, and 4(5.1%) for need of dialysis. The median duration of ICU stay and inotropic support were 4[3.0, 7.8] and 2[1.3, 4.0] days respectively. On multivariable regression, central venous pressure was significantly associated with operative mortality (odds ratio (OR) 1.14, 95%CI 1.02-1.27, p=0.02) and duration of inotropic support (OR 1.02, 95%CI 1.00-1.03, p=0.04). Preoperative cardiac index was also significantly inversely associated with duration of ICU stay (OR 0.72, 95%CI 0.62-0.84, p<0.001) and inotropic support (OR 0.76, 95%CI 0.63-0.92, p<0.01). Conclusion Despite inclusion of cardiogenic shock in STS-PROM, baseline central venous pressure and cardiac index are independently associated with operative mortality, inotrope requirement and duration of ICU stay in patients undergoing isolated CABG. Assessment of pre-operative right heart function by right heart catheterization should be considered in this high-risk population to guide pre-operative optimization and intra-/post-operative decision-making.