Frequency, risk factors and prognosis of postoperative hyperbilirubinemia after heart valve surgery.

Abstract:

OBJECTIVES:Despite recent advances in cardiovascular surgery, hyperbilirubinemia after heart valve surgery occurs often and the mechanism is not well clarified. We evaluated the incidence and nature of postoperative hyperbilirubinemia in heart valve surgery patients to analyze its risk factors and to identify its clinical significance for associated morbidity and mortality. METHODS:We investigated 334 consecutive patients who underwent heart valve surgery. Postoperative hyperbilirubinemia was defined as total serum bilirubin concentration greater than 3 mg/dl at any postoperative measurement point. RESULTS:Postoperative hyperbilirubinemia developed in 63 patients (19.0%) and was associated with greater in-hospital mortality (15.9 vs. 1.5%, p < 0.01). Univariate analysis revealed congestive heart failure history, cardiogenic shock, infective endocarditis, preoperative liver dysfunction, longer cardiopulmonary bypass time and transfusion as significantly related to postoperative hyperbilirubinemia. In multivariate analysis, preoperative liver dysfunction [odds ratio (OR) 6.5, p < 0.05] and longer cardiopulmonary bypass time (OR 1.007, p < 0.01) were independent predictors. In postoperative hyperbilirubinemia patients, preoperative New York Heart Association status and history of heart failure were associated with outcome. CONCLUSIONS:Postoperative hyperbilirubinemia remains common in patients undergoing heart valve surgery and is associated with a high rate of in-hospital mortality. For patients with heart failure or liver dysfunction, meticulous operative management is required to reduce cardiopulmonary bypass time and transfusion.

journal_name

Cardiology

journal_title

Cardiology

authors

Nishi H,Sakaguchi T,Miyagawa S,Yoshikawa Y,Fukushima S,Saito S,Ueno T,Kuratani T,Sawa Y

doi

10.1159/000338142

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

12-9

issue

1

eissn

0008-6312

issn

1421-9751

pii

000338142

journal_volume

122

pub_type

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