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Sleep Disorders: Sleep Disorders II |

Sleep Apnea Increase the Perioperative Risks of Heart Valve Replacement Surgery FREE TO VIEW

Ning Ding, PhD
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The First Affiliated Hospital of Nanjing Medical University, Nanjing, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A575. doi:10.1016/j.chest.2016.02.600
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SESSION TITLE: Sleep Disorders II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Studies have showed sleep apnea (SA) increase risks of ambulatory surgery, coronary artery bypass surgery, and colectomy. Despite the high prevalence of SA among patients referred to heart surgery, whether the present of SA increase the perioperative risks of cardiac valve replacement (CVR) surgery is not well established. Therefore, in the present study, we aimed to explore the potential impact of obstructive sleep apnea (OSA) and central sleep apnea (CSA) on postoperative events post-CVR surgery in rheumatic valvular heart disease (RVHD) patients.

METHODS: From April 2010 to April 2014, 290 patients with RVHD undergoing CVR surgery were screened for sleep apnea 1-7 days before CVR. The baseline medications, cardiac function, perioperative events and related risk factors were evaluated.

RESULTS: The results showed that left ventricular ejection fraction (LVEF) ≤ 60% was the only predictor for Cardiopulmonary Bypass Time ≥ 110min. NYHA Class ≥ 3 and present of OSA were the predictors for ICU Staying ≥ 25h. Predictive factors of Mechanical Ventilation ≥ 20h were NYHA Class ≥ 3, OSA and Age ≥ 50 years. Predictors of using Pacemaker were LVEF ≤ 60% and Pulmonary Arterial Hypertension (PAH). Predictor of First Dose of Dopamine ≥ 3 ug/kg/min was Age ≥ 50, and the predictors of First Dose of Dobutamine ≥ 3 ug/kg/min were PHA and CSA.

CONCLUSIONS: RVHD patients with SA have an increased incidence of post-CVR complications. OSA was independently associated with long time of ICU Staying and Mechanical Ventilation, and CSA was the risk of larger First Dose of Dobutamine.

CLINICAL IMPLICATIONS: High prevalence of sleep apnea (SA) were found in patients with rheumatic valvular heart disease. However, whether the present of SA increase the perioperative risks of cardiac valve replacement (CVR) surgery is not well established. In the present study, we aimed to explore the potential impact of SA on postoperative events post-CVR surgery and found RVHD patients with SA had an increased incidence of post-CVR complications.

DISCLOSURE: The following authors have nothing to disclose: Ning Ding

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