Faculty Collaboration Database

Cardiopulmonary Exercise Testing for Surgical Risk Stratification in Adults with Congenital Heart Disease. Pediatr Cardiol 2018 Oct;39(7):1468-1475

Date

06/09/2018

Pubmed ID

29882186

DOI

10.1007/s00246-018-1918-4

Scopus ID

2-s2.0-85048101818 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

Adult congenital heart disease (ACHD) patients often require repeat cardiothoracic surgery, which may result in significant morbidity and mortality. Currently, there are few pre-operative risk assessment tools available. In the general adult population, pre-operative cardiopulmonary exercise testing (CPET) has a predictive value for post-operative morbidity and mortality following major non-cardiac surgery. The utility of CPET for risk assessment in ACHD patients requiring cardiothoracic surgery has not been evaluated. Retrospective chart review was conducted on 75 ACHD patients who underwent CPET less than 12 months prior to major cardiothoracic surgery at Children's Hospital of Wisconsin. Minimally invasive procedures, cardiomyopathy, acquired heart disease, single ventricle physiology, and heart transplant patients were excluded. Demographic information, CPET results, and peri-operative surgical data were collected. The study population was 56% male with a median age of 25 years (17-58). Prolonged post-operative length of stay correlated with increased ventilatory efficiency slope (V_E/[Formula: see text] slope) (P = 0.007). Prolonged intubation time correlated with decreased peak HR (P = 0.008), decreased exercise time (P = 0.002), decreased heart rate response (P = 0.008) and decreased relative peak oxygen consumption (P = 0.034). Post-operative complications were documented in 59% of patients. While trends were noted between post-operative complications and some measurements of exercise capacity, none met statistical significance. Future studies may further define the relationship between exercise capacity and post-operative morbidity in ACHD patients.

Author List

Birkey T, Dixon J, Jacobsen R, Ginde S, Nugent M, Yan K, Simpson P, Kovach J

Authors

Salil Ginde MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin
Joshua Kovach MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Ke Yan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Cardiac Surgical Procedures
Exercise Test
Female
Heart Defects, Congenital
Humans
Length of Stay
Male
Middle Aged
Oxygen Consumption
Postoperative Complications
Preoperative Care
Retrospective Studies
Risk Assessment
Wisconsin
Young Adult