Enlargement of the Left Atrium Strongly Predicts Postoperative Mortality Following Heart Valve Surgery

Figures & data

Table 1 Distribution of Participants by Pre-Operative Mortality and Background Characteristics

		Not Dead		Dead		Total	P-value
		n	%	n	%
Overall		326	94.2%	20	5.8%	346
Age in Years (Mean)		50.70		65.60		51.56	0.000
BMI (mean)		26.34		29.03		26.50	0.003
Gender	Female	159	94.6%	9	5.4%	168	0.743
	Male	167	93.8%	11	6.2%	178
	Total	326	94.2%	20	5.8%	346
Operation Type	AVR	119	96.0%	5	4.0%	124	0.007
	MVR	95	96.0%	4	4.0%	99
	AVR + MVR	42	100.0%	0	0.0%	42
	AVR + CABG	15	78.9%	4	21.1%	19
	MVR + CABG	28	87.5%	4	12.5%	32
	AVR+MVR+CABG	3	100%	0	00.0%	3
	Others	24	88.9%	3	11.1%	27
	Total	326	94.2%	20	5.8%	346
Syncope	NO	280	94.9%	15	5.1%	295	0.150
	YES	39	100.0%	0	0.0%	39
	Total	319	95.5%	15	4.5%	334
Hypertension	NO	182	98.4%	3	1.6%	185	0.005
	YES	137	91.9%	12	8.1%	149
	Total	319	95.5%	15	4.5%	334
Diabetes	NO	248	95.8%	11	4.2%	259	0.822
	OHG	51	94.4%	3	5.6%	54
	Insulin	13	92.9%	1	7.1%	14
	Total	312	95.4%	15	4.6%	327
Smoking (never/ever)	Never smoked	222	94.9%	12	5.1%	234	0.448
	Ever smoked	91	96.8%	3	3.2%	94
	Total	313	95.4%	15	4.6%	328
History of HF	NO	244	94.9%	13	5.1%	257	0.435
	YES	68	97.1%	2	2.9%	70
	Total	312	95.4%	15	4.6%	327
Pre-operative Renal Impairment	NO	292	95.4%	14	4.6%	306	0.488
	YES	10	90.9%	1	9.1%	11
	Total	302	95.3%	15	4.7%	317
EF	Normal	162	95.3%	8	4.7%	170	0.941
	Mild	57	96.6%	2	3.4%	59
	Moderate	33	94.3%	2	5.7%	35
	Severe	15	93.8%	1	6.3%	16
	Total	267	95.4%	13	4.6%	280
Emergency / Urgent	Elective	295	95.2%	15	4.8%	310	0.018
	Urgent	13	81.3%	3	18.8%	16
	Total	308	94.5%	18	5.5%	326
ACE-I use	No or less than 1 month	243	94.6%	14	5.4%	257	0.140
	More than 1 month	72	98.6%	1	1.4%	73
	Total	315	95.5%	15	4.5%	330
B-blockers use	No or less than 1 month	107	91.5%	10	8.5%	117	0.010
	More than one month	207	97.6%	5	2.4%	212
	Total	314	95.4%	15	4.6%	329

Table 2 Distribution of Participants by Intra and Post-Operative Mortality Characteristics

		Not Dead		Dead		Total	P-value
		n	%	n	%
Overall		326	94.2%	20	5.8%	346
Type of valve used (aortic)	Biological	33	18.4%	2	6.0%	35	0.399
	Mechanical	146	81.6%	11	7.5%	232
	Total	179	100%	13	7.3%	346
Type of Valve (mitral)	Biological	28	16.7%	5	17.9%	32	0.016
	Mechanical	140	83.3%	4	2.9%	144
	Total	168	100%	9	5.4%	346
Pump Time	<120	196	95.6%	9	4.4%	205	0.214
	>120	67	91.8%	6	8.2%	73
	Total	263	94.6%	15	5.4%	278
Aorta cross Clamp time	< 90 MIN	203	97.1%	6	2.9%	209	0.007
	> 90 MIN	56	88.9%	7	11.1%	63
	Total	259	95.2%	13	4.8%	272
Intra Operative blood transfusion	No	246	95.3%	12	4.7%	258	0.687
	Yes	56	96.6%	2	3.4%	58
	Total	302	95.6%	14	4.4%	316
Re-exploration	No	299	95.8%	13	4.2%	312	0.019
	Yes	8	80.0%	2	20.0%	10
	Total	307	95.3%	15	4.7%	322
Prolonged Intropes Support (> 48 Hours)	NO	256	96.2%	10	3.8%	266	0.206
	Yes	48	92.3%	4	7.7%	52
	Total	304	95.6%	14	4.4%	318
Post-Operative Renal Failure	NO	298	95.8%	13	4.2%	311	0.044
	YES	10	83.3%	2	16.7%	12
	Total	308	95.4%	15	4.6%	323
Pnemonia/Sepsis	NO	303	95.9%	13	4.1%	316	0.531
	Pneumonia	12	92.3%	1	7.7%	13
	Total	315	95.7%	14	4.3%	329
ICU Stay	Less than one week	228	95.8%	10	4.2%	238	0.022
	More than one week	42	87.5%	6	12.5%	48
	Total	270	94.4%	16	5.6%	286
Post-Operative Stroke/TIA	NO	310	95.7%	14	4.3%	324	0.049
	YES	3	75.0%	1	25.0%	4
	Total	313	95.4%	15	4.6%	328
Sternal Infection	NO	314	95.7%	14	4.3%	328	0.047
	YES	3	75.0%	1	25.0%	4
	Total	317	95.5%	15	4.5%	332
LA Diameter before surgery	More than 4	182	91.0%	18	9.0%	200	0.003
	Less than or equal 4	144	98.6%	2	1.4%	146
	Total	326	94.2%	20	5.8%	346

Table 3 Adjusted Effect of Selected Variables on Perioperative Mortality

Variables		Not Dead		Dead		Total	Logistic Reression Results
		n	%	n	%		AOR	P-value
Overall		326	94.2%	20	5.8%	346
Age in Years (Mean)		50.70		65.60		51.56	1.083	0.032
BMI		26.34		29.03		26.50	1.213	0.003
ACE-i	No or less than 1 month	243	94.6%	14	5.4%	257	Ref.	0.173
	More than 1 month	72	98.6%	1	1.4%	73	0.071
	Total	315	95.5%	15	4.5%	330
Type of Valve (mitral)	Biological	28	84.4%	5	15.6%	32	Ref.	0.066
	Mechanical	140	97.2%	4	2.8%	144	0.040
	NO	159	93.5%	11	6.5%	170	0.108
	Total	326	94.2%	20	5.8%	346
Re-exploration	No	299	95.8%	13	4.2%	312	Ref.	0.006
	Yes	8	80.0%	2	20.0%	10	78.038
	Total	307	95.3%	15	4.7%	322
Aorta Cross Clamp time	< 90 MIN	203	97.1%	6	2.9%	209	Ref.	0.160
	> 90 MIN	56	88.9%	7	11.1%	63	3.589
	Total	259	95.2%	13	4.8%	272
ICU Stay	Less than one week	288	95.8%	10	4.2%	238	Ref.	0.002
	More than one week	42	87.5%	6	12.5%	48	44.555
	Total	330	94.4%	16	5.6%	346
LA Diameter before surgery	Less than or equal 4	144	98.6%	2	1.4%	146	Ref.	0.030
	More than 4	182	91.0%	18	9.0%	200	10.638
	Total	326	94.2%	20	5.8%	346