Left ventricular strain variations in cardiac surgery; The role of the type of surgery

Abstract

Introduction Perioperative alteration of 2D LV strain (AvgGLS) is associated with increased LOS and LCOS and poor outcome (1-3). To assess the intraopeative factors associated with AvgGLS deterioration after cardiac surgery we compared 2 cohorts of CABG vs AVR patients. Methods AvgGLS was measured by TEE under general anesthesia before and post-CPB (GE Vivid S7). We recorded demographic (Age, gender, preop conditions) and procedural (CPB, Clamp time, POD 1 troponine) data, early postoperative complications, ICU and hospital LOS, MACE (myocardial infarction, atrial fibrillation, ventricular arrhythmias, congestive heart failure, cardiac rehospitalization) occurence and survival. Two groups were compared according to type of surrgery: AVR vs CABG. A threshold of +10% was defined as a decrease of AvgGLS. We used Student t and KHI2 tests. Results 145 patients (AVR: 71(49%), CABG 74(51%)) with complete TEE were included. AvgGLS was decreased in 73.2% of AVR group and 62.1% of CABG group (NS). AVR and CABG groups were significantly different (p Discussion Despite significant anatomical and procedural differences, AVR and CABG patients have similar rate and depth of AvgGLS alteration after CPB. This result suggest that non procedural factors may ba responsible for AvgGLS alteration in cardiac surgery patients. The association of inflammatory response and AvgGLS alteration should be investigated.