Is vasoplegic syndrome more prevalent with open-heart procedures compared with isolated on-pump CABG surgery?

Cardiovasc Revasc Med. Jul-Aug 2011;12(4):203-9. doi: 10.1016/j.carrev.2010.10.004. Epub 2011 Mar 1.

Abstract

Postoperative vasoplegic syndrome (PVS) is a frequent complication and can affect the early postoperative course. Our study investigated the incidence and risk factors of PVS after on-pump isolated coronary artery grafting bypass (CABG) and on-pump open-heart surgery. A total of 629 patients underwent on-pump cardiac surgery from November 21, 2005, to June 9, 2006, at our institution. Of those, 334 patients underwent on-pump isolated CABG and 295 patients had open-heart surgery. PVS was defined based on the recognized criteria. Multivariate logistic regression analysis was used to identify the risk factors for PVS. The overall incidence of PVS was 11.7%. The incidence in isolated on-pump CABG surgery was 6.9% and 17.0% in open-heart surgery (P<.01). In multivariate analysis, isolated CABG reduced by half the incidence of PVS [odds ratio (OR)=0.45, P=.02]; preoperative left ventricular ejection fraction (EF) <35% was identified as an independent predictor of PVS (OR=2.1, P=.01), and a protective effect of female gender for PVS was observed (OR=0.4, P=.01). The association between angiotensin-converting enzyme inhibitors and other preoperative medical treatments was not confirmed by our study. In conclusion, PVS occurred less often after isolated CABG surgery than after open-heart surgery. Advanced age and low preoperative EF strongly predicted PVS.

MeSH terms

  • Aged
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / statistics & numerical data*
  • Coronary Artery Bypass, Off-Pump / adverse effects
  • Coronary Artery Bypass, Off-Pump / statistics & numerical data*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Vasoplegia / epidemiology*