HEART FAILURE IS ASSOCIATED WITH WORSE IN-HOSPITAL OUTCOMES IN PATIENTS UNDERGOING SURGICAL PULMONARY VALVE REPLACEMENT OR REPAIR: A NATIONWIDE STUDY

Document Type

Conference Proceeding

Publication Date

4-1-2025

Publication Title

J Am Coll Cardiol

Keywords

hypertensive factor, acute kidney failure, adult, aged, artificial ventilation, bleeding, cardiogenic shock, cardiovascular disease, Caucasian, cohort analysis, complication, conference abstract, extracorporeal oxygenation, female, heart arrest, heart failure, human, intraaortic balloon pump, major clinical study, male, mortality, mortality risk, observational study, pulmonary valve replacement, risk factor, ventricular assist device

Abstract

Background There is limited data on the safety of surgical pulmonary valve replacement (SPVR) or repair (SPVr) in patients with heart failure (HF). We examined complications of SPVR/SPVr in patients with HF Methods Patients ≥ 18 yo underwent SPVR/SPVr between 2018-2021 were identified from the National Inpatient Sample Database. The cohort was further categorized into patients with and without heart failure. In-hospital outcomes include mortality, cardiac arrest, cardiogenic shock, mechanical ventilation (MV), Vasopressor use, Impella or intra-aortic balloon pump (IABP), ECMO, bleeding and acute kidney injury (AKI). We tested association using multivariate logistic regression analyses Results There were 4574 SPVR/SPVr, 1819 (39%) were female, median age was 35 years (26-52), 3254 (71%) were white and 1755(38%) had heart failure. HF was associated with an increased risk of mortality (adjusted odds ratio aOR 3.85 (95% CI 1.03-12.38); p-value 0.04), cardiac arrest (aOR 3.44 (1.03-11.4); 0.04, cardiogenic shock aOR 3.66 (2.34-5.74);<.0001, MV 1.75 (1.01-3.04); 0.04), vasopressor use (2.12 (1.37-3.28); 0.0007), Impella or IABP (4.52 (1.06-19.1); 0.04) and AKI (1.62 (1.11-2.36); 0.01) Figure Conclusion There is an increased risk of mortality and adverse cardiovascular events in patients with heart failure undergoing surgical pulmonary valve replacement or repair. Further research is needed to identify modifiable risk factors for better outcomes and optimize surgical timing and planning. [Formula presented]

Volume

85

Issue

12

First Page

956

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