Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement Surgery
AimsTo evaluate the clinical efficiency of on-table extubation (OTE) versus delayed extubation in patients aged over 60 years that underwent minimally invasive mitral or aortic valve replacement surgery and evaluate the factors associated with successful OTE implementation.MaterialsPatients over 60...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-06-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.934044/full |
| _version_ | 1828195659628412928 |
|---|---|
| author | Yunfen Ge Yue Chen Zhibin Hu Hui Mao Qiong Xu Qing Wu |
| author_facet | Yunfen Ge Yue Chen Zhibin Hu Hui Mao Qiong Xu Qing Wu |
| author_sort | Yunfen Ge |
| collection | DOAJ |
| description | AimsTo evaluate the clinical efficiency of on-table extubation (OTE) versus delayed extubation in patients aged over 60 years that underwent minimally invasive mitral or aortic valve replacement surgery and evaluate the factors associated with successful OTE implementation.MaterialsPatients over 60 years with mitral or aortic valve disease who received minimally invasive mitral or aortic valve replacement surgery from October 2020 to October 2021 were selected retrospectively. We divided patients into the on-table extubated (OTE) group (n = 71) and the delayed extubation (DE) group (n = 22). Preoperative, intraoperative, and postoperative clinical variables were compared between the two groups.ResultsPatients in the DE group underwent longer surgery time, longer aortic occlusion clamping time and longer cardiopulmonary bypass time than those in the OTE group(217.48 ± 27.83 vs 275.91 ± 77.22, p = 0.002; 76.49 ± 16.00 vs 126.55 ± 54.85, p = 0.001; 112.87 ± 18.91 vs 160.77 ± 52.17, p = 0.001). Patients in the OTE group had shorter postoperative mechanical ventilation time (min), shorter ICU time, shorter postoperative hospital length of stay and lower total cost and medication cost (p < 0.05). The AUC for aortic occlusion clamping time was 0.81 (p < 0.01), making it the most significant predictor of on-table extubation success.ConclusionsOn-table extubation following mitral or aortic valve cardiac surgery was associated with a superior clinical outcome and high cost-effectiveness. |
| first_indexed | 2024-04-12T09:47:21Z |
| format | Article |
| id | doaj.art-27a26d2e39f94febbe396d7cd8a37117 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T09:47:21Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-27a26d2e39f94febbe396d7cd8a371172022-12-22T03:37:54ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-06-01910.3389/fsurg.2022.934044934044Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement SurgeryYunfen Ge0Yue Chen1Zhibin Hu2Hui Mao3Qiong Xu4Qing Wu5Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, ChinaCenter for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, ChinaHeart Center, Department of Cardiovascular Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, ChinaCenter for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, ChinaCenter for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, ChinaCenter for Reproductive Medicine, Department of Gynecology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, ChinaAimsTo evaluate the clinical efficiency of on-table extubation (OTE) versus delayed extubation in patients aged over 60 years that underwent minimally invasive mitral or aortic valve replacement surgery and evaluate the factors associated with successful OTE implementation.MaterialsPatients over 60 years with mitral or aortic valve disease who received minimally invasive mitral or aortic valve replacement surgery from October 2020 to October 2021 were selected retrospectively. We divided patients into the on-table extubated (OTE) group (n = 71) and the delayed extubation (DE) group (n = 22). Preoperative, intraoperative, and postoperative clinical variables were compared between the two groups.ResultsPatients in the DE group underwent longer surgery time, longer aortic occlusion clamping time and longer cardiopulmonary bypass time than those in the OTE group(217.48 ± 27.83 vs 275.91 ± 77.22, p = 0.002; 76.49 ± 16.00 vs 126.55 ± 54.85, p = 0.001; 112.87 ± 18.91 vs 160.77 ± 52.17, p = 0.001). Patients in the OTE group had shorter postoperative mechanical ventilation time (min), shorter ICU time, shorter postoperative hospital length of stay and lower total cost and medication cost (p < 0.05). The AUC for aortic occlusion clamping time was 0.81 (p < 0.01), making it the most significant predictor of on-table extubation success.ConclusionsOn-table extubation following mitral or aortic valve cardiac surgery was associated with a superior clinical outcome and high cost-effectiveness.https://www.frontiersin.org/articles/10.3389/fsurg.2022.934044/fullmitral or aortic valve diseaseon-table extubationdelayed extubationaortic occlusion clampingcardiopulmonary bypass time |
| spellingShingle | Yunfen Ge Yue Chen Zhibin Hu Hui Mao Qiong Xu Qing Wu Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement Surgery Frontiers in Surgery mitral or aortic valve disease on-table extubation delayed extubation aortic occlusion clamping cardiopulmonary bypass time |
| title | Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement Surgery |
| title_full | Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement Surgery |
| title_fullStr | Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement Surgery |
| title_full_unstemmed | Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement Surgery |
| title_short | Clinical Evaluation of on-Table Extubation in Patients Aged Over 60 Years Undergoing Minimally Invasive Mitral or Aortic Valve Replacement Surgery |
| title_sort | clinical evaluation of on table extubation in patients aged over 60 years undergoing minimally invasive mitral or aortic valve replacement surgery |
| topic | mitral or aortic valve disease on-table extubation delayed extubation aortic occlusion clamping cardiopulmonary bypass time |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.934044/full |
| work_keys_str_mv | AT yunfenge clinicalevaluationofontableextubationinpatientsagedover60yearsundergoingminimallyinvasivemitraloraorticvalvereplacementsurgery AT yuechen clinicalevaluationofontableextubationinpatientsagedover60yearsundergoingminimallyinvasivemitraloraorticvalvereplacementsurgery AT zhibinhu clinicalevaluationofontableextubationinpatientsagedover60yearsundergoingminimallyinvasivemitraloraorticvalvereplacementsurgery AT huimao clinicalevaluationofontableextubationinpatientsagedover60yearsundergoingminimallyinvasivemitraloraorticvalvereplacementsurgery AT qiongxu clinicalevaluationofontableextubationinpatientsagedover60yearsundergoingminimallyinvasivemitraloraorticvalvereplacementsurgery AT qingwu clinicalevaluationofontableextubationinpatientsagedover60yearsundergoingminimallyinvasivemitraloraorticvalvereplacementsurgery |