IMPLICATION OF PULMONARY ARTERY SYSTOLIC PRESSURE FOR PROLONGED CARDIOPULMONARY BYPASS DURATION IN PATIENTS UNDERGOING RE-REPAIR FOR DEGENERATIVE MITRAL REGURGITATION

Abstract

Objective: Emerging evidence revealed that the longer duration of cardiopulmonary bypass (CPB) during cardiac surgery renders patients at higher risk of adverse outcomes. However, little is known regarding the risk factor of prolonged CPB in patients undergoing re-repair of degenerative mitral regurgitation (DMR). We aimed to explore the prognostic significance of pulmonary artery systolic pressure (PASP) on CPB duration in patients undergoing re-repair of DMR. Design and method: Patients with DMR undergoing re-repair in our center were consecutively enrolled from Jan 2009 to Dec 2021. Patients were stratified into the prolonged CPB group (CPB time < 132 min, n = 61) and the shorter CPB (CPB time < 132, n = 59). Preoperative Univariable and multivariable logistic regression analyses were used to evaluate the impact of PASP on the risk of prolonged CPB duration. Results: Of the 120 patients enrolled, 61 had prolonged CPB time (50.8%). The mean preoperative PASP was higher in the prolonged CPB group compared with the shorter CPB group (45.2±21.9 vs. 37.7±15.1, P < 0.05). CPB time increased with higher preoperative PASP (P < 0.05). For per 10 units of pre-PASP value increase in patients undergoing re-repair for DMR, there were 1.25 times more likely to be associated with a prolonged CPB time (adjusted odds ratio [OR] 1.25, 95% confidence interval [CI] 1.01-1.56, P < 0.05). Patients with preoperative PASP > 50mmHg had an adjusted OR of 3.66 (95% CI 1.36-9.84, P < 0.05) for a prolonged CPB period compared with those with preoperative PASP < 50mmHg. Conclusions: Preoperative PASP in patients requiring re-repair for DMR was associated with a higher likelihood of an extended time of CPB. Regular screening of pulmonary hypertension may aid in perioperative risk-stratification in patients prior to re-repair for DMR.