The incidence of vasoplegia in adult patients with right-sided congenital heart defects undergoing cardiac surgery and the correlation with serum vasopressin concentrations.

Abstract

BACKGROUND:

In adults with right-sided congenital heart disease, vasoplegia during and after cardiopulmonary bypass appears to be a frequent complication. The incidence of vasoplegia in the general adult and pediatric cardiac surgical population has been investigated, but the incidence in adult patients with right-sided congenital heart disease is unknown. Perioperative vasopressin levels during cardiac surgery have been studied in other cardiac surgical patients, but are not known in adults with right-sided congenital heart disease. The purpose of this study was to investigate the incidence of vasoplegia in adult patients undergoing right-sided cardiac surgical procedures requiring cardiopulmonary bypass and to determine the vasopressin response to cardiac surgery in this population.

METHODS:

Twenty patients were enrolled and demographic, hemodynamic, cardiopulmonary bypass, and use of vasoactive medication data were collected. In addition, perioperative serum vasopressin levels were measured. Sixty adult patients undergoing left-sided cardiac surgery served as controls.

RESULTS:

The incidence of vasoplegia in the control patients was 10% and the incidence in the adult patients with right-sided congenital heart disease was 20%. Vasopressin levels were low at baseline (0.5 ± 0.5 pg/mL), increased slightly after induction of anesthesia (0.6 ± 0.6 pg/mL), increased after initiation of cardiopulmonary bypass (99.7 ± 168.2 pg/mL), and decreased after surgery (31.3 ± 43.6 pg/mL).

CONCLUSIONS:

This study showed that the incidence of vasoplegia (20%) in patients with right-sided congenital heart disease undergoing cardiac surgery was double that of a population of patients undergoing aortic valve surgery (10%). Serum vasopressin concentration was not associated with vasoplegia in this population of congenital cardiac surgical patients.

• Authors: Erica D Wittwer, James J Lynch, William C Oliver Jr, Joseph A Dearani, Harold M Burkhart, William J Mauermann
• Journal: The Journal of thoracic and cardiovascular surgery (J Thorac Cardiovasc Surg) Vol. 148 Issue 2 Pg. 625-30 (Aug 2014) ISSN: 1097-685X [Electronic] United States
• PMID: 24280713 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Chemical References

• Biomarkers
• Vasopressins

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Cardiac Surgical Procedures (adverse effects)
• Cardiopulmonary Bypass (adverse effects)
• Female
• Heart Defects, Congenital (blood, surgery)
• Hemodynamics
• Humans
• Incidence
• Male
• Middle Aged
• Minnesota (epidemiology)
• Prospective Studies
• Risk Factors
• Time Factors
• Treatment Outcome
• Vasoplegia (blood, diagnosis, epidemiology, physiopathology)
• Vasopressins (blood)
• Young Adult