Clinical research studyImpact of Severe Mitral Regurgitation on Postoperative Outcomes After Noncardiac Surgery
Section snippets
Patient Population
All adults (aged > 18 years) undergoing any noncardiac surgery between January 2005 and February 2009 with echocardiographically diagnosed moderate-severe or severe mitral regurgitation (referred to as “significant mitral regurgitation”) before surgery were identified from the echocardiography and surgical databases maintained at the Cleveland Clinic. We determined the mechanism of mitral regurgitation by reviewing electronic medical records, echocardiograms, and coronary angiograms. The
Patient Characteristics
A total of 7510 patients underwent planned noncardiac surgery between January 2005 and February 2009 at the Cleveland Clinic. Significant mitral regurgitation was present in 298 patients. Of 298 patients, 102 (34%) had ischemic mitral regurgitation and 196 (66%) had nonischemic mitral regurgitation. Nonischemic mitral regurgitation was of varied cause, including 94 (31%) functional, 41 (14%) degenerative, 15 (5%) hypertrophic cardiomyopathy–induced, 10 (3%) rheumatic heart disease, 8 (3%)
Discussion
Our study investigated the impact of significant mitral regurgitation on the postoperative outcomes after noncardiac surgeries stratified by mechanism of mitral regurgitation. We observed that the patients with significant mitral regurgitation experienced higher primary adverse outcome consisting of 30-day mortality, heart failure, myocardial infarction, and stroke. The significant difference in the primary outcome was accounted for, largely, by an increased incidence of heart failure and
Conclusions
Patients with significant mitral regurgitation undergoing noncardiac surgery experienced higher rates of primary outcome consisting of 30-day mortality, heart failure, myocardial infarction, and stroke, in comparison with patients without mitral regurgitation. The significant difference in the primary outcome was largely accounted for by an increased incidence of heart failure and myocardial infarction in the postoperative period among patients with significant ischemic mitral regurgitation.
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Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.