Patient Characteristics and Operative Details
A total of 293 cardiac surgical patients were included in this study
with CPB time ≥ 300 minutes. Baseline patient demographics are
summarized in Table 1 . Median age and body mass index were 62
years and 28.1 kg/m2, respectively. Patients were
predominately of male sex and white race. The majority of patients were
also of New York Heart Association class 1 symptoms (65.2%) and 32.4%
had a prior history of heart failure. Median Society of Thoracic
Surgeons predicted risk of mortality was 2.5% (IQR 1.3% – 4.7%). A
total of 6 patients (2.0%) had preoperative mechanical support (4
intra-aortic balloon pump (IABP), 2 extracorporeal membrane oxygenation
(ECMO)).
A breakdown of performed operations are displayed in Table 2 .
The most common operation performed in this cohort was aortic root
replacement (34.5%), followed by double valve procedure (23.6%) and
combined coronary artery bypass grafting and aortic valve replacement
(9.6%). Forty-four percent of cases were performed in an elective
setting, while 20.5% were performed as an emergent and/or salvage
procedure. A total of 116 (39.6%) cases were redo operations. Median
CPB time in this cohort was 340.0 minutes (IQR 315.0 – 385.0 minutes),
and median cross clamp time was 254.0 minutes (IQR 204.0 – 298.0
minutes). Median CPB time was longest in the combined CABG and aortic
valve replacement group (350.5 minutes, IQR 325.5 – 397.5 minutes).
IABP was utilized intraoperatively in 20.1% of cases, and ECMO was used
intraoperatively in 7.2% of cases (Table 3 ). Postoperative
IABP or ECMO were used in 6 (2.1%) and 2 (0.7%) cases, respectively.
No patients received a ventricular assist device intraoperatively or
postoperatively.