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Thorac Cardiovasc Surg 2024; 72(07): 539-541
DOI: 10.1055/a-2263-1933
Short Communication

Impact of Age on the Relationship between Cross-Clamp Time and Mortality in Cardiac Surgery

Murat Mukharyamov
1   Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena, Jena, Germany
,
Hristo Kirov
1   Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena, Jena, Germany
,
Tulio Caldonazo
1   Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena, Jena, Germany
,
Torsten Doenst
1   Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena, Jena, Germany
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Abstract

Age is an independent risk factor for mortality even when all known comorbidities are considered. Thus, other factors may additionally contribute to the age-associated risk. We performed a systematic literature search and identified 161 manuscripts, of which 32 studies (18,256 patients) were analyzed. Cross-clamp time correlated with observed mortality. The increase in mortality risk with cross-clamp time was much greater in older patients than in younger patients. The log odds ratio (OR) for age and cross-clamp time was 0.07 and 0.01, respectively, which was highly significant for both independent risk factors. Age accelerates the increase in mortality risk with increasing aortic cross-clamp times.

Keywords

myocardial protection/cardioplegia (including metabolism) - outcomes (includes mortality, morbidity) - cardiopulmonary bypass


Publication History

Received: 08 November 2023

Accepted: 04 February 2024

Accepted Manuscript online:
07 February 2024

Article published online:
16 April 2024

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  • References

  • 1 Sullivan PG, Wallach JD, Ioannidis JP. Meta-analysis comparing established risk prediction models (EuroSCORE II, STS score, and ACEF score) for perioperative mortality during cardiac surgery. Am J Cardiol 2016; 118 (10) 1574-1582
    CrossrefPubMedSearch in Google Scholar
  • 2 Mariani J, Ou R, Bailey M. et al. Tolerance to ischemia and hypoxia is reduced in aged human myocardium. J Thorac Cardiovasc Surg 2000; 120 (04) 660-667
    CrossrefPubMedSearch in Google Scholar
  • 3 Doenst T, Borger MA, Weisel RD, Yau TM, Maganti M, Rao V. Relation between aortic cross-clamp time and mortality: not as straightforward as expected. Eur J Cardiothorac Surg 2008; 33 (04) 660-665
    CrossrefPubMedSearch in Google Scholar
  • 4 Shultz B, Timek T, Davis AT. et al. Outcomes in patients undergoing complex cardiac repairs with cross clamp times over 300 minutes. J Cardiothorac Surg 2016; 11 (01) 105
    CrossrefPubMedSearch in Google Scholar
  • 5 Willems L, Zatta A, Holmgren K, Ashton KJ, Headrick JP. Age-related changes in ischemic tolerance in male and female mouse hearts. J Mol Cell Cardiol 2005; 38 (02) 245-256
    CrossrefPubMedSearch in Google Scholar