Postcardiotomy mechanical support in patients with mitral valve prostheses is associated with poor survival

Int J Artif Organs. 2022 Feb;45(2):127-133. doi: 10.1177/0391398820982621. Epub 2020 Dec 18.


Aims: To elaborate on early survival in patients with mitral valve replacement requiring temporary extracorporeal life support system (ECLS).

Methods: We analyzed survival, significant bleeding, wound infection, and ECLS duration in 421 from 14,400 patients with postoperative need for ECLS from January 2008 to December 2017 at our institution. Finally, patients were stratified according to the type of surgery performed: the mitral group (mitral valve replacement) n = 63 and the control group (any cardiac surgery excluding the mitral valve) n = 358. In order to adjust for preoperative patient characteristics, a propensity matching analysis was performed. Differences in in-hospital mortality were analyzed accordingly.

Results: In-hospital mortality was significantly higher in the mitral group as compared to the control group before and after adjustment (p < 0.001). Median duration of ECLS was 4 days in both groups. Perioperative bleeding (p < 0.001) and wound infection (p < 0.001) also showed significant worse outcome parameters in the mitral group. The main causes of death in the mitral group were multiorgan failure, n = 48 (76%), stroke, n = 7 (12%), and intracardiac thrombus formation, n = 5 (10%).

Conclusions: ECLS is associated with a high in-hospital mortality rate in patients after mitral valve replacement.

Keywords: Cardiothoracic surgery; ECLS; artificial kidney; mitral valve; postcardiotomy syndrome; valves.

MeSH terms

  • Cardiac Surgical Procedures*
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis*
  • Humans
  • Mitral Valve / surgery
  • Retrospective Studies
  • Treatment Outcome