Anisocytosis as a possible predictor of low cardiac output syndrome in children undergoing mitral valve surgery
Advances in Medical Sciences(2024)
摘要
Purpose
Mitral valve surgery in children involves correcting congenital and acquired pathologies, with a reported mortality rate of 0.9%. Low cardiac output syndrome (LCOS) is a serious complication with the incidence of 20–25%. The aim of the study was to estimate possible prognostic factors of LCOS in children undergoing mitral valve procedure.
Material and method
This single-center retrospective analysis enrolled children aged <18 years who underwent mitral valve surgery during 24 year period. Preoperative clinical and laboratory parameters, and operative factors were analyzed.
Results
Thirty consecutive pediatric patients (11 (37%) males and 19 (63%) females) in median (Q1 – Q3) age of 57 (25–115) months, who underwent mitral valve replacement, were included. The 30-day mortality was 7% (2 patients) and was related to postoperative multiorgan failure. LCOS occurred in 8 (27%) children. The receiver operator curve (ROC) analysis established parameters that have predictive value for LCOS occurrence: cardiopulmonary bypass (CPB) time, with 89 min as optimal cut-off point (AUC = 0.744, p = 0.011) yielding sensitivity of 100% and specificity of 42.9%; left ventricular ejection fraction (LVEF) < 60 % (AUC = 0.824, okp = 0.001) with sensitivity of 62.5% and specificity of 93.75%; and red blood cell distribution width (RDW) above 14.5 % (AUC = 0.840, p < 0.001; sensitivity of 87.5% and specificity of 75%).
Conclusions
In mitral valve replacement in pediatric patients, CPBtime above 89 min, preoperative LVEF below 60% and preoperative RDW above 14.5% can be regarded as the potential predictors of LCOS.
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关键词
Anisocytosis,Mitral valve surgery,Low cardiac output syndrome
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