Document Detail

Significant correlation of comprehensive Aristotle score with total cardiac output during the early postoperative period after the Norwood procedure.
MedLine Citation:
PMID:  18603064     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The comprehensive Aristotle score has been proposed as an individualized measure of the complexity of a given surgical procedure and has been reported to significantly correlate with postoperative morbidity and mortality after the Norwood procedure. An important factor leading to postoperative morbidity and mortality is low cardiac output. We studied the correlation between the comprehensive Aristotle score and cardiac output (CO) in infants after the Norwood procedure. METHODS AND RESULTS: Respiratory mass spectrometry was used to continuously measure systemic oxygen consumption (VO(2)) in 22 infants for 72 hours postoperatively. Arterial, superior vena caval and pulmonary venous blood gases were measured at 2 to 4 hour intervals to calculate CO. The comprehensive Aristotle score was collected. Hospital mortality was 4.5%. The comprehensive Aristotle score ranged from 14.5 to 23.5 and negatively correlated with CO (P = 0.027). Among the patient-adjusted factors, myocardial dysfunction (n = 10), mechanical ventilation to treat cardiorespiratory failure (n = 9) and atrioventricular valve regurgitation (n = 4) (P = 0.01) negatively correlated with CO (P = 0.06 to 0.07). Aortic atresia (n = 9) was associated with a lower CO (P = 0.01) for the first 24 hours which linearly increased overtime (P = 0.0001). No correlation was found between CO and other factors (P > 0.3 for all). CONCLUSIONS: Comprehensive Aristotle score significantly negatively correlates with CO after the Norwood procedure. A preoperative estimation of the comprehensive Aristotle score, particularly in association with myocardial dysfunction, mechanical ventilation to treat cardiorespiratory failure, atrioventricular valve regurgitation and aortic atresia may help to anticipate a high postoperative morbidity with low cardiac output syndrome.
Jia Li; Gencheng Zhang; Helen Holtby; Sally Cai; Mark Walsh; Christopher A Caldarone; Glen S Van Arsdell
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-07
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  136     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  123-8     Citation Subset:  AIM; IM    
The Labbatt Family Heart Center, the Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Body Weight
Cardiac Output
Cardiac Surgical Procedures / statistics & numerical data*
Heart Defects, Congenital / classification*,  physiopathology,  surgery*
Infant, Newborn
Oxygen Consumption
Postoperative Complications / diagnosis,  epidemiology*,  prevention & control*
Postoperative Period*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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