Does Myocardial Oxygen Extraction Depend on Preoperative Functional Class in Beating Heart Atrial Septal Defect Repair
MYOCARDIAL OXYGEN EXTRACTION DOES NOT DEPEND ON PREOPERATIVE FUNCTIONAL CLASS
Abstract
BACKGROUND: To determine the effect of preoperative functional class on myocardial oxygen extraction in patients undergoing Beating Heart repair of Atrial Septal Defect (ASD).
METHODS: 140 consecutive patients with secondum Atrial Septal Defect were operated on beating heart with normothermicnormokalemic(370 C, 4.5mmol/L) bypass without cross-clamping the aorta between January 2016 to December 2018. Patients above 15 years of age and having high school as minimum qualification were enrolled. All patients with ASD size of smaller than 2 cm, those with associated cardiac anomalies, with accompanying co-morbidities, and age more than 65 years were excluded. Patients were classified as per New York Heart Association (NYHA) criteria. We sought to determine whether the preoperative NYHA functional class has any effect on myocardial oxygen extraction.
RESULTS: There were 84 females (60%) and 56 males (40%) with a female: male ratio of 1.5. The age of patients ranged between 18 ─65 years with a mean age of 42 ± 4.2. Elderly patients were found to have a higher functional class as per NYHA classification. Functional class improvement was 37% from NYHA class IV to III, 18.5% from IV toII, 7.4% from IV to I, 51.6 % from III to II, 30.2% from III to I, and 71.1% from II to I after one year of follow up. Overall myocardial oxygen extraction in Volume%, ( 12.4 ± 3.1) was comparable to that seen in a normal healthy beating heart at rest. Our study determined that there was no difference in myocardial oxygen extraction in different NYHA classes.
CONCLUSION: Preoperative NYHA functional class does not affect myocardial oxygen extraction in patients operated on beating heart.
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References
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