Prolonged Cardiopulmonary Bypass Time as a Predictive Factor for AGI After Heart Valve Replacement

Study Overview
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Brief Summary
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In this retrospective study, the investigators will analyze the correlation between cardiopulmonary bypass (CPB) time and acute gastrointestinal injury (AGI), and the outcomes of AGI in patients undergoing heart valve replacement.

Detailed Description
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Patients with heart valve diseases often have chronic cardiac insufficiency. Patients undergoing heart valve replacement with CPB are always complicated with gastrointestinal tract ischemia-reperfusion injury, which usually leads to AGI. AGI after cardiovascular surgery, especially in that use CPB, is associated with significant morbidity and an increase in peri-operative mortality. Prolonged CPB time could be predictive of AGI following heart valve replacement. This study is to analyze the correlation between CPB time and AGI, and the outcomes of AGI in patients undergoing heart valve replacement. The investigators hope that the benefits will include fewer patients becoming seriously postoperative AGI and mortality after cardiac surgery.

Official Title
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Prolonged Cardiopulmonary Bypass (CPB) Time as a Predictive Factor for Acute Gastrointestinal Injury (AGI) After Heart Valve Replacement

Conditions
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Heart Valve Diseases

Intervention / Treatment
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* Other: CPB time


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing heart valve replacement surgery with CPB Age > 18 years and ≤ 70 years Exclusion Criteria: Patients combined with severe hematological disease, respiratory disease, and other critical diseases Patients had severe disorder of multiple systems and organs or severe pulmonary hypertension Have received major gastrointestinal surgery within 5 years Inflammatory bowel disease (IBD), including ulcerative colitis, Crohn's disease, or colitis Acute gastroenteritis Clostridium difficile or Helicobacter pylori infection Chronic constipation Peptic ulcer Polyps in the stomach or intestines Gastrointestinal neoplasms Abdominal hernia Irritable bowel syndrome Acute or chronic cholecystitis, hepatitis Patients who died during surgery Patients with digestive system tumors

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CPB time ≥ 90 minutes<br>No intervention, regular therapy | Other: CPB time<br>* Cardiopulmonary bypass time<br>|
| CPB time < 90 minutes<br>No intervention, regular therapy | Other: CPB time<br>* Cardiopulmonary bypass time<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiopulmonary bypass (CPB) time | Was defined it as the sum of times of CPB during surgery (minutes). | 1 month | 
| The AGI score | The AGI score of the patient within the seventh postoperative day was performed according to the European Society of critical care (2012) guidelines for AGI. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of bowel sounds | The return time of bowel sounds was evaluated morning and evening. | 1 month | 
| First defecation time | The time to the first defecation was asked morning and evening after surgery | 1 month | 
| Proportion of cocci and bacilli in feces | The first feces were collected in sterile containers for the bacterial smear | 1 month | 
| Alanine aminotransferase (ALT) | We defined it as the maximum value of ALT within 7 days after surgery. | 1 month | 
| Aspartate aminotransferase (AST) | We defined it as the maximum value of AST within 7 days after surgery | 1 month | 
| Left ventricular ejection fraction (LVEF) | We measured the LVEF on the 1st and 3rd days after operation by echocardiographic examinations | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Heart valve diseases, Gastrointestinal tract