Cardiac surgery with cardiopulmonary bypass (CPB) improves survival in patients with cardiovascular diseases, but postoperative complications like postcardiotomy low cardiac output syndrome, vasoplegic syndrome and excessive bleeding contribute to high morbidity and mortality. This study examines the relationship between these complications and adverse in-hospital outcomes.
Methods
This retrospective study included 555 adult patients who underwent cardiac surgery with CPB. Postoperative complications were assessed, and their associations with outcomes like prolonged ICU stays, morbidity, and in-hospital mortality were analyzed. Logistic regression was used to identify predictors of adverse outcomes.
Results
Patients were grouped based on the number of postoperative syndromes experienced. Group 4 (three syndromes) had the highest rates of complications, including delirium, cerebrovascular events, and in-hospital mortality. Logistic regression showed that two or more postoperative syndromes were significant predictors of severe complications and mortality.
Conclusions
Multiple postoperative syndromes significantly increase the risk of adverse outcomes after cardiac surgery with CPB. Early identification and targeted management of these patients can reduce ICU time, improve recovery, and enhance long-term survival.
{"title":"Impact of postoperative syndromes on adverse outcomes in cardiac surgery with cardiopulmonary bypass: A retrospective study on morbidity and in-hospital mortality","authors":"Jorge Armando Zelada-Pineda , Rodrigo Gopar-Nieto , Gustavo Rojas-Velasco , Daniel Manzur-Sandoval","doi":"10.1016/j.circv.2025.03.005","DOIUrl":"10.1016/j.circv.2025.03.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac surgery with cardiopulmonary bypass (CPB) improves survival in patients with cardiovascular diseases, but postoperative complications like postcardiotomy low cardiac output syndrome, vasoplegic syndrome and excessive bleeding contribute to high morbidity and mortality. This study examines the relationship between these complications and adverse in-hospital outcomes.</div></div><div><h3>Methods</h3><div>This retrospective study included 555 adult patients who underwent cardiac surgery with CPB. Postoperative complications were assessed, and their associations with outcomes like prolonged ICU stays, morbidity, and in-hospital mortality were analyzed. Logistic regression was used to identify predictors of adverse outcomes.</div></div><div><h3>Results</h3><div>Patients were grouped based on the number of postoperative syndromes experienced. Group 4 (three syndromes) had the highest rates of complications, including delirium, cerebrovascular events, and in-hospital mortality. Logistic regression showed that two or more postoperative syndromes were significant predictors of severe complications and mortality.</div></div><div><h3>Conclusions</h3><div>Multiple postoperative syndromes significantly increase the risk of adverse outcomes after cardiac surgery with CPB. Early identification and targeted management of these patients can reduce ICU time, improve recovery, and enhance long-term survival.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 1","pages":"Pages 19-25"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac surgeries, which include procedures for congenital heart defects, valve replacements, and coronary artery bypass grafting, are increasingly performed worldwide. Despite extensive data from regions such as the U.S. and Europe, Latin American data remain scarce. Postoperative pneumonia, a significant complication in cardiac surgery, poses serious risks including high mortality and extended critical care resource use.
Methods
This retrospective, cross-sectional study evaluated 485 patients who underwent cardiac surgery with extracorporeal circulation at the National Institute of Cardiology Ignacio Chávez between June 1, 2022, and December 31, 2023. Patients were included based on specific criteria, and those with incomplete records or other infections were excluded. Data collection involved reviewing medical records and imaging studies, with statistical analyses including logistic regression to identify risk factors and outcomes associated with postoperative pneumonia.
Results
Out of 485 patients, 45 developed pneumonia after surgery. Risk factors included age over 60, cerebrovascular disease, combined coronary bypass and aortic valve replacement, and blood transfusions. Pneumonia was associated with severe complications, including higher mortality rates, extended ICU and hospital stays, and increased mechanical ventilation. Chest X-rays were the primary diagnostic tool, and gram-negative bacteria were the most frequently identified pathogens.
Conclusions
Postoperative pneumonia presents a serious challenge in cardiac surgery patients, with substantial impacts on patient outcomes and healthcare resources. Early diagnosis and targeted treatment are crucial, emphasizing the need for improved prevention and management strategies.
{"title":"Demographic, clinical, surgical characteristics, and outcomes of postoperative pneumonia in cardiac surgery patients at a Latin American tertiary care center","authors":"Adrián Sotelo-Soleno , Guadalupe Lisseth Hernández-González , Rodrigo Gopar-Nieto , Gustavo Rojas-Velasco , Daniel Manzur-Sandoval","doi":"10.1016/j.circv.2024.11.004","DOIUrl":"10.1016/j.circv.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac surgeries, which include procedures for congenital heart defects, valve replacements, and coronary artery bypass grafting, are increasingly performed worldwide. Despite extensive data from regions such as the U.S. and Europe, Latin American data remain scarce. Postoperative pneumonia, a significant complication in cardiac surgery, poses serious risks including high mortality and extended critical care resource use.</div></div><div><h3>Methods</h3><div>This retrospective, cross-sectional study evaluated 485 patients who underwent cardiac surgery with extracorporeal circulation at the National Institute of Cardiology Ignacio Chávez between June 1, 2022, and December 31, 2023. Patients were included based on specific criteria, and those with incomplete records or other infections were excluded. Data collection involved reviewing medical records and imaging studies, with statistical analyses including logistic regression to identify risk factors and outcomes associated with postoperative pneumonia.</div></div><div><h3>Results</h3><div>Out of 485 patients, 45 developed pneumonia after surgery. Risk factors included age over 60, cerebrovascular disease, combined coronary bypass and aortic valve replacement, and blood transfusions. Pneumonia was associated with severe complications, including higher mortality rates, extended ICU and hospital stays, and increased mechanical ventilation. Chest X-rays were the primary diagnostic tool, and gram-negative bacteria were the most frequently identified pathogens.</div></div><div><h3>Conclusions</h3><div>Postoperative pneumonia presents a serious challenge in cardiac surgery patients, with substantial impacts on patient outcomes and healthcare resources. Early diagnosis and targeted treatment are crucial, emphasizing the need for improved prevention and management strategies.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 1","pages":"Pages 26-31"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.circv.2024.11.010
Iván Martín-González , Claudia M. Aguirre-Ramón , Carlos Domínguez-Massa , Audelio Guevara-Bonilla , José A. Rincón-Almanza , Tomás Heredia-Cambra
Introduction
Castor™ (MicroPort®) is a single-branched thoracic endograft platform for a partial arch sealing. Even Castor™ instructions for use are for type B aortic dissections, its use in real-world is spreading along other aortic diseases.
The objective is to analize the endograft Castor™ from our initial experience.
Methods
Description of endograft Castor™ and its implantation.
Description of 2 clinical cases.
Results
There are several tips and tricks for an adequate Castor™ implantation: 8 F Flexor® (Cook) sheath × 110 cm for guiding the traction wire, working projection of the left subclavian artery ostium for delivery, maneuvers for twisted wires and branch alignment, blood pressure control for aortic graft opening with inferior vena cava endoclamping or rapid ventricular pacing.
Case 1 is a 54-year-old male with a chronic post-traumatic pseudoaneurysm at zone 3. Case 2 is a 59-year-old male with a subacute type B aortic dissection (Tb,E3,M3-) with high-risk factors (radiological and clinical). Both Castor™ devices were implanted at zone 2 via right common femoral artery (percutaneously).
Postoperative course was uneventful for major complications and tomography control was satisfactory for both cases.
At follow-up (case 1 with 3,5 months; case 2 with 1 month), the clinical status was fine.
Conclusions
In our short initial experience, as well as literature experience, Castor™ is a safe single-branched device for arch sealing, even further studies are needed for long-term outcomes.
This device has several steps that should be followed for a succesful implantation.
{"title":"TEVAR ramificado en zona 2 con endoprótesis Castor™: experiencia inicial. Consejos y trucos en implante","authors":"Iván Martín-González , Claudia M. Aguirre-Ramón , Carlos Domínguez-Massa , Audelio Guevara-Bonilla , José A. Rincón-Almanza , Tomás Heredia-Cambra","doi":"10.1016/j.circv.2024.11.010","DOIUrl":"10.1016/j.circv.2024.11.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Castor™ (MicroPort®) is a single-branched thoracic endograft platform for a partial arch sealing. Even Castor™ instructions for use are for type B aortic dissections, its use in real-world is spreading along other aortic diseases.</div><div>The objective is to analize the endograft Castor™ from our initial experience.</div></div><div><h3>Methods</h3><div>Description of endograft Castor™ and its implantation.</div><div>Description of 2 clinical cases.</div></div><div><h3>Results</h3><div>There are several tips and tricks for an adequate Castor™ implantation: 8<!--> <!-->F Flexor® (Cook) sheath × 110<!--> <!-->cm for guiding the traction wire, working projection of the left subclavian artery ostium for delivery, maneuvers for twisted wires and branch alignment, blood pressure control for aortic graft opening with inferior vena cava endoclamping or rapid ventricular pacing.</div><div>Case 1 is a 54-year-old male with a chronic post-traumatic pseudoaneurysm at zone 3. Case 2 is a 59-year-old male with a subacute type B aortic dissection (Tb,E3,M3-) with high-risk factors (radiological and clinical). Both Castor™ devices were implanted at zone 2 via right common femoral artery (percutaneously).</div><div>Postoperative course was uneventful for major complications and tomography control was satisfactory for both cases.</div><div>At follow-up (case 1 with 3,5 months; case 2 with 1 month), the clinical status was fine.</div></div><div><h3>Conclusions</h3><div>In our short initial experience, as well as literature experience, Castor™ is a safe single-branched device for arch sealing, even further studies are needed for long-term outcomes.</div><div>This device has several steps that should be followed for a succesful implantation.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 1","pages":"Pages 32-40"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.circv.2025.06.003
Jesús Moreno Rodríguez, Maydeline Lorenzo Díaz, Ramón Aranda Domene, Sergio Juan Cánovas López, María March Salas, María José Alcaraz García, Jesús Pérez Morote, Rosalía Sánchez Motos, Almudena Amor Vigueras, María Ponce de León Torralba, José María Avilés Alvizu, María del Mar Galindo Rueda, María Clemente Murcia
Introduction
Comprehensive care of the cardiosurgical patient is essential to optimize clinical results. In this context, preoperative strategies play a key role, with accelerated recovery programs (ERAS) being a promising alternative.
Objective
To evaluate the psychological and metabolic effects of prolonged fasting (>8 h) in patients undergoing elective cardiac surgery, comparing them with a group receiving carbohydrate supplementation.
Methodology
Quasi-experimental, prospective and randomized study. Patients were assigned to two groups: (1) Carbohydrate supplementation and (2) Prolonged fasting. Clinical variables, capillary blood glucose, anxiety (Hamilton Scale), feeling of hunger and thirst, perceived satisfaction and postoperative complications were measured.
Results
58 patients were included. The intervention group presented a lower sensation of hunger and thirst (p < 0.001), as well as a significant reduction in pre-surgical anxiety (p = 0.003) compared to the control group. Perceived satisfaction was also higher in the intervention group (p = 0.047). No significant differences were detected in capillary blood glucose levels between the groups. Neither was a greater need for insulin administration observed in either group. Regarding postoperative complications, no significant differences were observed, nor were there any cases of mortality attributable to the procedure.
Conclusions
Preoperative supplementation with carbohydrate-rich fluids improves the patient experience in terms of anxiety and comfort, without compromising metabolic stability or increasing the incidence of postoperative complications. The findings found throughout the research support the incorporation of this strategy into cardiac surgery protocols, with the potential to optimize patient experience and outcomes.
{"title":"Evaluate psychological effects of prolonged fasting in patients undergoing cardiac surgery","authors":"Jesús Moreno Rodríguez, Maydeline Lorenzo Díaz, Ramón Aranda Domene, Sergio Juan Cánovas López, María March Salas, María José Alcaraz García, Jesús Pérez Morote, Rosalía Sánchez Motos, Almudena Amor Vigueras, María Ponce de León Torralba, José María Avilés Alvizu, María del Mar Galindo Rueda, María Clemente Murcia","doi":"10.1016/j.circv.2025.06.003","DOIUrl":"10.1016/j.circv.2025.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Comprehensive care of the cardiosurgical patient is essential to optimize clinical results. In this context, preoperative strategies play a key role, with accelerated recovery programs (ERAS) being a promising alternative.</div></div><div><h3>Objective</h3><div>To evaluate the psychological and metabolic effects of prolonged fasting (>8<!--> <!-->h) in patients undergoing elective cardiac surgery, comparing them with a group receiving carbohydrate supplementation.</div></div><div><h3>Methodology</h3><div>Quasi-experimental, prospective and randomized study. Patients were assigned to two groups: (1) Carbohydrate supplementation and (2) Prolonged fasting. Clinical variables, capillary blood glucose, anxiety (Hamilton Scale), feeling of hunger and thirst, perceived satisfaction and postoperative complications were measured.</div></div><div><h3>Results</h3><div>58 patients were included. The intervention group presented a lower sensation of hunger and thirst (<em>p</em> <!--><<!--> <!-->0.001), as well as a significant reduction in pre-surgical anxiety (<em>p</em> <!-->=<!--> <!-->0.003) compared to the control group. Perceived satisfaction was also higher in the intervention group (<em>p</em> <!-->=<!--> <!-->0.047). No significant differences were detected in capillary blood glucose levels between the groups. Neither was a greater need for insulin administration observed in either group. Regarding postoperative complications, no significant differences were observed, nor were there any cases of mortality attributable to the procedure.</div></div><div><h3>Conclusions</h3><div>Preoperative supplementation with carbohydrate-rich fluids improves the patient experience in terms of anxiety and comfort, without compromising metabolic stability or increasing the incidence of postoperative complications. The findings found throughout the research support the incorporation of this strategy into cardiac surgery protocols, with the potential to optimize patient experience and outcomes.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 1","pages":"Pages 5-10"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.circv.2025.06.004
Jhon Alexander Barrero , Fernando Andrés Rada , Catalina Vásquez Casas , Diana Marcela Franco , Juan David Diaz , Kelly Maileth Murgas , Laura Melisa Pulido , Angie Michell Garzón , Laura Victoria Briñez , Gilma Hernandez , Jaime Camacho Mackenzie
Objectives
To estimate the quality of life of patients who underwent cardiac surgery, identify the EuroQol 5-Dimension 5-Level (EQ-5D-5L) dimensions that are most affected and determine which clinical factors are associated with a poor quality of life.
Design
Cross-sectional study with an analytical component.
Location
Hospital in Bogotá (Colombia).
Participants
People over 18 years of age who underwent cardiac surgery in 2022 (n = 257).
Intervention
Telephone survey.
Results
A total of 81.9% of the patients who underwent cardiac surgery considered their quality of life to be good. The most compromised EQ-5D-5L dimensions were pain or discomfort and anxiety or depression. The variables that were associated with poor quality of life were the Lawton-Brody scale (odds ratio (OR) = 0.67), being older than 60 years (OR = 2.64), presence of pain or discomfort (OR = 3.89) and a poor support network (OR = 3.07).
Conclusions
At an average of 20 months after surgery, the quality of life of patients who underwent cardiac surgery was good. The generation of strategies that integrate the family in patient care, strategies that improve the ability to perform instrumental activities of daily living and pain control could improve quality of life in this patient population.
{"title":"La calidad de vida de los pacientes después de una cirugía cardiaca en un hospital de Colombia","authors":"Jhon Alexander Barrero , Fernando Andrés Rada , Catalina Vásquez Casas , Diana Marcela Franco , Juan David Diaz , Kelly Maileth Murgas , Laura Melisa Pulido , Angie Michell Garzón , Laura Victoria Briñez , Gilma Hernandez , Jaime Camacho Mackenzie","doi":"10.1016/j.circv.2025.06.004","DOIUrl":"10.1016/j.circv.2025.06.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To estimate the quality of life of patients who underwent cardiac surgery, identify the EuroQol 5-Dimension 5-Level (EQ-5D-5L) dimensions that are most affected and determine which clinical factors are associated with a poor quality of life.</div></div><div><h3>Design</h3><div>Cross-sectional study with an analytical component.</div></div><div><h3>Location</h3><div>Hospital in Bogotá (Colombia).</div></div><div><h3>Participants</h3><div>People over 18 years of age who underwent cardiac surgery in 2022 (n<!--> <!-->=<!--> <!-->257).</div></div><div><h3>Intervention</h3><div>Telephone survey.</div></div><div><h3>Results</h3><div>A total of 81.9% of the patients who underwent cardiac surgery considered their quality of life to be good. The most compromised EQ-5D-5L dimensions were pain or discomfort and anxiety or depression. The variables that were associated with poor quality of life were the Lawton-Brody scale (odds ratio (OR)<!--> <!-->=<!--> <!-->0.67), being older than 60 years (OR<!--> <!-->=<!--> <!-->2.64), presence of pain or discomfort (OR<!--> <!-->=<!--> <!-->3.89) and a poor support network (OR<!--> <!-->=<!--> <!-->3.07).</div></div><div><h3>Conclusions</h3><div>At an average of 20 months after surgery, the quality of life of patients who underwent cardiac surgery was good. The generation of strategies that integrate the family in patient care, strategies that improve the ability to perform instrumental activities of daily living and pain control could improve quality of life in this patient population.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 1","pages":"Pages 11-18"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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