Abstract 11039: Impact of Mitral Regurgitation on Post-Operative outcomes in Non Cardiac Surgeries
Introduction: The preoperative cardiac risk assessment scoring systems traditionally do not include valvular regurgitation as a criterion for adverse outcome prediction. We performed this study to assess the impact of significant mitral regurgitation (MR) on the post-operative outcomes after non-cardiac surgeries (NCS).
Methods: Patients with moderate-severe or severe MR were identified using the surgical and the echocardiographic database at the Cleveland Clinic. Using propensity score analysis, we obtained 4 matched controls (patient undergoing NCS without MR) for each case. We compared primary outcome which was a composite of 30-day mortality, myocardial infarction (MI), heart failure and stroke among the two groups. We also compared secondary outcomes including inpatient mortality, myocardial infarction, heart failure, stroke, atrial fibrillation and pulmonary embolism.
Results: A total of 297 cases and 1172 controls were included. We found the primary composite outcome to occur in 66 (22.2 %) cases and 192 (16.4 %) controls (p=0.02). Analysis of secondary outcomes revealed significant differences in perioperative heart failure [odds ratio OR (95% confidence interval CI): 1.4 (1.02-2.0)] and perioperative myocardial infarction [OR (95% CI): 2.9 (1.2-7.3)]. No significant differences in 30-day mortality, stroke, atrial fibrillation and pulmonary embolism between the two groups.(Table 1)
Conclusion: Moderate-severe or severe MR was a significant risk factor for an adverse post-operative outcome, evidenced by higher rates of composite outcome consisting of short-term mortality, heart failure, MI and stroke. The significant difference in the primary outcome was driven by increased incidence of heart failure and MI in patients with significant MR.
- © 2011 by American Heart Association, Inc.