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The Impact of Hyponatremia in Aortic Valve Surgery Using Histidine–Tryptophan–Ketoglutarate Cardioplegia Cover

The Impact of Hyponatremia in Aortic Valve Surgery Using Histidine–Tryptophan–Ketoglutarate Cardioplegia

Open Access
|Sep 2024

Figures & Tables

FIGURE 1.

ROC curve analysis of preoperative Na levels in predicting 7-day postoperative mortality
ROC curve analysis of preoperative Na levels in predicting 7-day postoperative mortality

FIGURE 2.

ROC curve analysis of preoperative Na levels in predicting 30-day postoperative mortality
ROC curve analysis of preoperative Na levels in predicting 30-day postoperative mortality

Baseline characteristics of patients according to preoperative Na levels

VariablesNa ≤ 136 mmol/l (n = 119)Na > 136 mmol/l (n = 183)p value
Age (n, %)
  <60 years31 (26.1)54 (29.5)0.002*
  61–70 years48 (40.3)91 (49.7)0.056
  >70 years40 (33.6)38 (20.8)0.545
Female (n, %)38 (31.9)72 (39.3)0.924
Comorbidities (n, %)
  Dyslipidemia43 (36.1)76 (41.5)0.258
  Obesity21 (17.6)39 (21.3)0.830
  Diabetes mellitus23 (19.3)46 (25.1)0.430
  Arterial hypertension78 (65.5)140 (76.5)0.968
Preoperative echocardiography
  LVEF, % (median, 95% CI)55.0 (50.0–55.0)55.0 (50.0–55.0)0.841#
  Ao max gradient, mmHg (median, 95% CI)80.0 (75.0–84.0)80.0 (77.0–85.0)0.389#
  Ao medium gradient, mmHg (median, 95% CI)48.0 (45.3–52.7)49.0 (46.0–53.0)0.564#
  LV diastolic diameter, mm (median, 95% CI)53.0 (52.0–55.0)52.0 (50.0–54.0)0.099#
Preoperative blood levels
  pH (median, 95% CI)7.45 (7.42–7.47)7.42 (7.41–7.43)0.022#*
  Lactate, mmol/l (median, 95% CI)1.4 (1.4–1.5)1.3 (1.2–1.4)0.015#*
  Surgery duration, min (mean ± s.d.)337.5 ± 81.4402.1 ± 264.1<0.001#*
  Bypass duration, min (mean ± s.d.)122.5 ± 53.193.8 ± 34.1<0.001#*
  Aortic clamp duration, min (mean ± s.d.)81.3 ± 34.466.7 ± 23.8<0.001#*
  Postoperative orotracheal intubation, h (mean ± s.d.)13.7 ± 15.99.9 ± 10.0<0.001#*
  Postoperative inotropic/vasopressor support, days (mean ± s.d.)1.8 ± 1.91.6 ± 2.00.018#*
Postoperative echocardiography
  LVEF, % (median, 95% CI)50.0 (45.0–55.0)50.0 (45.0–55.0)0.253#
  Ao max gradient, mmHg (median, 95% CI)22.0 (20.0–24.0)21.0 (18.0–23.0)0.804#
  Ao medium gradient, mmHg (mean ± s.d.)8.0 (7.0–8.0)7.0 (6.8–8.0)0.225#
Postoperative blood levels
  Na, mmol/l (median, 95% CI)134.8 (133.6–135.5)134.9 (134.7–135.6)0.253#
  pH (median, 95% CI)7.42 (7.39–7.45)7.45 (7.42–7.47)0.197#
  Lactate, mmol/l (median, 95% CI)1.4 (1.3–1.7)1.5 (1.4–1.7)0.847#

Postoperative outcomes

VariablesNa ≤ 136 mmol/l (n = 119)Na > 136 mmol/l (n = 183)OR (95% CI)p value
Surgical reintervention (n, %)10 (8.4)5 (2.7)3.65 (1.18–11.34)0.025#*
New onset of AFib (n, %)8 (6.7)19 (10.4)0.73 (0.30–1.77)0.485#
Sustained VT/VF (n, %)2 (1.7)3 (1.6)0.39 (0.07–2.01)0.259#
Neurological impairment (n, %)1 (0.8)3 (1.6)0.35 (0.03–3.77)0.384#
7-day mortality (n, %)9 (7.6)2 (1.1)7.40 ((1.57–34.90)0.011*
30-day mortality (n, %)13 (10.9)3 (1.6)7.36 (2.05–26.42)0.002*
DOI: https://doi.org/10.2478/jce-2024-0015 | Journal eISSN: 2457-5518 | Journal ISSN: 2457-550X
Language: English
Page range: 95 - 101
Submitted on: Aug 1, 2024
Accepted on: Aug 21, 2024
Published on: Sep 30, 2024
Published by: Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year

© 2024 Claudiu Ghiragosian, Dragos-Florin Baba, Marius Harpa, Alexandra Puscas, Radu Balau, Hussam Al Hussein, Simina Elena Ghiragosian-Rusu, Calin Avram, Radu Mircea Neagoe, Horatiu Suciu, published by Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.