Predictors of low cardiac output syndrome after isolated coronary artery bypass surgery: trends over 20 years

Algarni, Khaled D.; Maganti, Manjula; Yau, Terrence M.

doi:10.1016/j.athoracsur.2011.06.017

Cited by 153Cardiac and Coronary Surgery TechniquesMechanical Circulatory Support DevicesTransplantation: Methods and Outcomes

Predictors of low cardiac output syndrome after isolated coronary artery bypass surgery: trends over 20 years

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Algarni, Khaled D., Maganti, Manjula, Yau, Terrence M.·2011·The Annals of Thoracic Surgery

DOI 10.1016/j.athoracsur.2011.06.017

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Abstract

Background Postoperative low cardiac output syndrome (LCOS) is associated with high morbidity and mortality after coronary artery bypass grafting (CABG). We sought to examine trends in predictors of LCOS after isolated CABG.Methods A total of 25,176 consecutive patients who underwent isolated CABG between 1990 and 2009 were included. To examine trends over time, we divided patients into four equivalent eras (1990 to -1994, n = 6,489; 1995 to 1999, n = 8,175; 2000 to 2004, n = 6,741; 2005 to 2009, n = 3,797). We used multivariable analysis to identify predictors of LCOS.Results The prevalence of LCOS declined from 9.1% (1990 to 1994) to 2.4% (2005 to 2009, p < 0.001). The following were the major independent predictors of LCOS for the entire cohort (odds ratios in parentheses): reoperative CABG (4.1); earlier year of operation (4.1, 2.6, 1.7 for the first, second, and third eras, respectively); left ventricular ejection fraction (LVEF) less than 0.20 (3.5), emergency surgery (2.7), cardiogenic shock (2.3), female gender (2), and LVEF 0.20 to 0.39 (2). Unlike other risk factors, the impact of LVEF less than 0.20 on development of postoperative LCOS increased substantially in the latest era (odds ratio, 7.8) compared with (odds ratios, 3.1, 4.3, and 3.2) the first, second, and third eras, respectively.Conclusions The impact of LVEF less than 0.20 on development of postoperative LCOS has increased markedly in the latest era of our study. Prudent preoperative evaluation in patients with severe left ventricular dysfunction is critical. Further innovative research in myocardial protection and circulatory support is warranted in patients with severe left ventricular dysfunction.

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The reported incidence of LCOS varies from 2 to 27% in the adult population.
“The reported incidence of LCOS varies from 2 to 27% in the adult population (2–8).”
From Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study (2022) · cites this paper as [3]
The Abstract (page unavailable) reports that LCOS prevalence after isolated coronary artery bypass surgery is 3%–14%, and Operative and Hospital Outcomes reports 2.4%–9.1% across this study’s eras. These passages support variation in LCOS prevalence, but not the claimed 2%–27% range or its extension to the adult population generally. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Low cardiac output syndrome, caused by inadequate cardiac pump function, is a serious complication after cardiac surgery with high morbidity and mortality.
“Low cardiac output syndrome, caused by an inadequate cardiac pump function, is a serious complication after cardiac surgery with high morbidity and mortality (2–4, 6, 8, 12).”
From Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study (2022) · cites this paper as [3]

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Low-Cardiac-Output Syndrome After Cardiac Surgery
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“Regarding postoperative complications, patients who died had a significantly higher rate of LCOS (75 vs. 32 %, p 0.001), cardiogenic shock (55 vs. 3.4 %, p 0.001), AKI (86 vs. 21 %, p 0.001), sepsis (11 vs. 2.7 %, p = 0.01), and severe pulmonary dysfunction (27 vs. 2.7 %, p 0.001).”
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Result
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“5 L/min/m(2)) and low peripheral resistance were also not considered to have LCOS.(14) PMI was defined as a serum creatine kinase-myocardial band (CK-MB) value 5 times greater than the upper limit of normal (>85 U/L) with new Q waves present, or a CK-MB level 10 times greater than the upper limit of normal (<170 U/L),…”
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Incidence and Predictors of Postoperative Need for High-Dose Inotropic Support in Patients Undergoing Cardiac Surgery for Infective Endocarditis
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Background
Low cardiac output syndrome in the postoperative period of cardiac surgery. Profile, differences in clinical course and prognosis. The ESBAGA study
Vela, J. L. P., Rivera, J. J. J., Llorente, M. A., de Marcos, B. G., Torrado, H., Laborda, C. G., Zamora, M. D. F., Fernández, F. J. G., & Benitez, J. C. M. (2018) · Medicina Intensiva (English Edition) · doi:10.1016/j.medine.2018.03.001 · Cited by 24 · see citing works
Cardioplegia between Evolution and Revolution: From Depolarized to Polarized Cardiac Arrest in Adult Cardiac Surgery
Francica, A., Tonelli, F., Rossetti, C., Tropea, I., Luciani, G. B., Faggian, G. G., Dobson, G. P., & Onorati, F. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10194485 · Cited by 23 · see citing works
“Stunning is currently reported in about 10% of adults following cardiac surgery with depolarizing cardioplegic arrest; it contributes to low cardiac output syndrome, whose incidence is reported to range between 3% and 14% after CABG; furthermore, low cardiac output syndrome is associated with a from 10- to 17- fold in…”
Background
A new machine learning algorithm to predict veno-arterial ECMO implantation after post-cardiotomy low cardiac output syndrome
Morisson, L., Duceau, B., Rego, H. D., Lancelot, A., Hariri, G., Charfeddine, A., Langlois, P. L., Richebé, P., Lebreton, G., Provenchère, S., et al. (2022) · Anaesthesia Critical Care & Pain Medicine · doi:10.1016/j.accpm.2022.101172 · Cited by 23 · see citing works
Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery: An Update Meta-Analysis and Trial Sequential Analysis
Wang, B., He, X., Gong, Y., & Cheng, B. (2018) · BioMed Research International · doi:10.1155/2018/7563083 · Cited by 22 · see citing works
High Central Venous-to-Arterial CO2 Difference is Associated With Poor Outcomes in Patients After Cardiac Surgery: A Propensity Score Analysis
Chen, T., Pan, T., Luo, X., & Wang, D. (2019) · Shock · doi:10.1097/shk.0000000000001324 · Cited by 21 · see citing works
The efficacy and safety of prophylactic use of levosimendan on patients undergoing coronary artery bypass graft: a systematic review and meta-analysis
Wang, W., Zhou, X., Liao, X., Liu, B., & Yu, H. (2019) · Journal of Anesthesia · doi:10.1007/s00540-019-02643-3 · Cited by 20 · see citing works
Predictors and associated clinical outcomes of low cardiac output syndrome following cardiac surgery: insights from the LEVO-CTS trial
Kochar, A., Zheng, Y., van Diepen, S., Mehta, R. H., Westerhout, C. M., Mazer, C. D., Duncan, A. I., Whitlock, R. P., Lópes, R. D., Argenziano, M., et al. (2022) · European Heart Journal Acute Cardiovascular Care · doi:10.1093/ehjacc/zuac114 · Cited by 20 · see citing works
Vasoactive Drugs and Hemodynamic Monitoring in Pediatric Cardiac Intensive Care
Rizza, A., Bignami, E. G., Belletti, A., Polito, A., Ricci, Z., Isgrò, G., Locatelli, A., & Cogo, P. E. (2015) · World Journal for Pediatric and Congenital Heart Surgery · doi:10.1177/2150135115606626 · Cited by 19 · see citing works
“Cardiovascular dysfunction has a higher incidence in children than in adults, where the prevalence of postcardiac surgery LCOS has declined significantly over time (from 9% in 1990 to 2% post2005).(4) In this setting, hemodynamic monitoring plays a key role in the care of LCOS.”
Background
Improving risk assessment for post-surgical low cardiac output syndrome in patients without severely reduced ejection fraction undergoing open aortic valve replacement. The role of global longitudinal strain and right ventricular free wall strain
Balderas-Muñoz, K., Rodríguez‐Zanella, H., Fritche‐Salazar, J. F., Ávila-Vanzzini, N., Orozco, L. E. J., Arias‐Godínez, J. A., Arguelles, O. C., Peralta, S. R., Sauza‐Sosa, J. C., Ruiz-Esparza, M. E., et al. (2017) · International journal of cardiac imaging · doi:10.1007/s10554-017-1139-6 · Cited by 19 · see citing works
Levosimendan in Cardiac Surgery: Evaluating the Evidence
Faisal, S., Apatov, D. A., Ramakrishna, H., & Weiner, M. M. (2018) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2018.05.035 · Cited by 19 · see citing works
Risk factors of postoperative low cardiac output syndrome in children with congenital heart disease: A systematic review and meta-analysis
Wang, P., Fu, C., Bai, G., Cuan, L., Tang, X., Jin, C., Jin, H., Zhu, J., & Xie, C. (2023) · Frontiers in Pediatrics · doi:10.3389/fped.2022.954427 · Cited by 20 · see citing works
Levosimendan use in patients with preoperative low ejection fraction undergoing cardiac surgery: A systematic review with meta-analysis and trial sequential analysis.
Ng, K., Chan, X., Tan, W., & Wang, C.-Y. (2019) · Journal of clinical anesthesia · doi:10.1016/j.jclinane.2018.08.019 · Cited by 16 · see citing works
Right Ventricular Longitudinal Strain Predicts Low-Cardiac- Output Syndrome After Surgical Aortic Valve Replacement in Patients With Preserved and Mid-range Ejection Fraction
Posada‐Martínez, E. L., Fritche‐Salazar, J. F., Arias‐Godínez, J. A., Ortiz‐León, X. A., Balderas-Muñoz, K., Ruiz-Esparza, M. E., Sánchez, E. A., Sandoval, J. P., Morales, A. K. T., & Rodríguez‐Zanella, H. (2020) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2020.12.008 · Cited by 17 · see citing works
Preservation of renal function in cardiac surgery patients with low cardiac output syndrome: levosimendan vs beta agonists
Orriach, J. L. G., Arce, I. N., Rodriguez, P. F., Ponferrada, A. R., Malo-Manso, A., Aliaga, M. R., Fernández, A., Escalona-Belmonte, J. J., Bellido-Estévez, I., Luque, A. G., et al. (2019) · BMC Anesthesiology · doi:10.1186/s12871-019-0888-2 · Cited by 17 · see citing works
Is Peripheral Artery Disease an Independent Predictor of Isolated Coronary Artery Bypass Outcome?
Bonacchi, M., Parise, O., Matteucci, F., Tetta, C., Moula, A. I., Micali, L. R., Dokollari, A., Martino, M. D., Sani, G., Grasso, A., et al. (2020) · Heart Lung and Circulation · doi:10.1016/j.hlc.2020.01.013 · Cited by 17 · see citing works
Association between In-hospital Mortality and Low Cardiac Output Syndrome with Morning versus Afternoon Cardiac Surgery
Hijazi, R. M., Sessler, D. I., Liang, C., Rodriguez-Patarroyo, F. A., Soltesz, E. G., & Duncan, A. E. (2021) · Anesthesiology · doi:10.1097/aln.0000000000003728 · Cited by 16 · see citing works
Levosimendan versus placebo in cardiac surgery: a systematic review and meta-analysis
Tena, M. Á., Urso, S., González-Martín, J. M., Santana, L., Sádaba, R., Juarez, P. T., González, L., & Portela, F. (2018) · Interactive Cardiovascular and Thoracic Surgery · doi:10.1093/icvts/ivy133 · Cited by 15 · see citing works
Establishment of Predictive Models for Nonocclusive Mesenteric Ischemia Comparing 8,296 Control with 452 Study Patients
Bomberg, H., Stroeder, J., Karrenbauer, K., Groesdonk, H. V., Wagenpfeil, S., Klingele, M., Bücker, A., Schäfers, H., & Minko, P. (2018) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2018.08.194 · Cited by 15 · see citing works
Utility of NT-proBNP as an objective marker of postoperative heart failure after coronary artery bypass surgery: a prospective observational study
Jiang, H., Holm, J., Friberg, Ö., Vánky, F. B., Vidlund, M., Tajik, B., Yang, Y., & Svedjeholm, R. (2021) · Perioperative Medicine · doi:10.1186/s13741-021-00194-4 · Cited by 14 · see citing works
Predictors and clinical outcomes of post-coronary artery bypass grafting cerebrovascular strokes
Laimoud, M. H., Maghirang, M. J., Alanazi, M., Al-Mutlaq, S., Althibait, S. A., Alanazi, B., Alomran, M., & Al‐Halees, Z. (2022) · The Egyptian Heart Journal · doi:10.1186/s43044-022-00315-4 · Cited by 17 · see citing works
“Post-cardiotomy low cardiac output syndrome (LCOS) represents a life-threatening state with severe reduction in cardiac systolic function and cardiac index resulting in impaired global tissue perfusion, multi-organ dysfunction and increased mortality [17, 18].”
Background
Prediction of Short-Term Mortality With Renal Replacement Therapy in Patients With Cardiac Surgery-Associated Acute Kidney Injury
Han, H., Wen, Z., Wang, J., Zhāng, P., Gong, Q., Ge, S., & Duan, J. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.738947 · Cited by 14 · see citing works
“2 L·min−1·m−2, after optimizing preload and afterload, as well as correcting all electrolyte and blood gas abnormalities (15).”
Background
Development and Validation of a Prediction Score for Low-Cardiac-Output Syndrome After Adult Cardiac Surgery
Mendes, M. A., Fabre, M., Amabili, P., Jaquet, O., Donneau, A., Bonhomme, V. L., & Hans, G. A. (2023) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2023.06.025 · Cited by 13 · see citing works
Effect of levosimendan on renal function in background of left ventricular dysfunction: a meta-analysis of randomized trials
Long, Y., Cui, D., Kuang, X., Hu, Y., Hu, S., Wang, C., & Liu, Z. (2021) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2021.1951700 · Cited by 13 · see citing works
Rationale and design of the multicenter randomized trial investigating the effects of levosimendan pretreatment in patients with low ejection fraction (≤40 %) undergoing CABG with cardiopulmonary bypass (LICORN study)
Caruba, T., Hourton, D., Sabatier, B., Rousseau, D., Tibi, A., Hoffart-Jourdain, C., Souag, A., Freitas, N., Yjjou, M., Almeida, C., et al. (2016) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-016-0530-z · Cited by 13 · see citing works
“14 % [1], but the presence of a preoperative left ventricular dysfunction (i.”
BackgroundInfluential
Levosimendan in patients with left ventricular dysfunction undergoing cardiac surgery: a meta-analysis and trial sequential analysis of randomized trials
Xing, Z., Tang, L., Chen, P., Huang, J., Peng, X., & Hu, X. (2018) · Scientific Reports · doi:10.1038/s41598-018-26206-w · Cited by 11 · see citing works
Identifying and mitigating risk of postcardiotomy cardiogenic shock in patients with ischemic and nonischemic cardiomyopathy
Javorski, M. J., Bauza, K., Xiang, F., Soltesz, E. G., Chen, L., Bakaeen, F. G., Svensson, L. G., Thuita, L. W., Blackstone, E. H., & Tong, M. Z. (2024) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2024.02.025 · Cited by 11 · see citing works
Transesophageal Echocardiography, 3-Dimensional and Speckle Tracking Together as Sensitive Markers for Early Outcome in Patients With Left Ventricular Dysfunction Undergoing Cardiac Surgery
Kumar, A., Puri, G. D., & Bahl, A. (2017) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2017.04.006 · Cited by 11 · see citing works
Six-Month Outcomes After High-Risk Coronary Artery Bypass Graft Surgery and Preoperative Intra-aortic Balloon Counterpulsation Use: An Inception Cohort Study
Litton, E., Bass, F. E., Delaney, A. P., Hillis, G. S., Marasco, S., McGuinness, S., Myles, P. S., Reid, C. M., Smith, J. A., Bagshaw, S. M., et al. (2018) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2018.01.005 · Cited by 11 · see citing works
Quantitative Transthoracic Echocardiography of the Response to Dobutamine in Cardiac Surgery Patients With Low Cardiac Output Syndrome
Zarragoikoetxea, I., Vicente, R., Pajares, A., Carmona, P. I., Lopez, M., Moreno, I., Argente, P., Hornero, F., Valera, F., & Agüero, J. (2019) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2019.08.019 · Cited by 12 · see citing works
Temporary mechanical circulatory support prevents the occurrence of a low‐output state in high‐risk coronary artery bypass grafting: A case series
Smith, N. J., Ramamurthi, A., Joyce, L. D., Durham, L. A., Kohmoto, T., & Joyce, D. L. (2021) · Journal of Cardiac Surgery · doi:10.1111/jocs.15309 · Cited by 11 · see citing works
“Despite this knowledge, up to 17% of patients with LVD will experience an LOS with a multifold increase in mortality, which has been sustained over several decades.(4,5,7) This highlights the difficulty in the prevention of this poor prognostic factor.”
BackgroundMethod
Volume-associated hemodynamic variables for prediction of cardiac surgery-associated acute kidney injury
Xu, J., Jiang, W., Li, Y., Shen, B., Shen, Z., Wang, Y., Hu, J., Fang, Y., Luo, Z., Wang, C., et al. (2020) · Clinical and Experimental Nephrology · doi:10.1007/s10157-020-01908-6 · Cited by 9 · see citing works
The multivariable prognostic models for severe complications after heart valve surgery
Liu, Y., Xiao, J., Duan, X., Lu, X., Gong, X., Chen, J., Xiong, M., Yin, S., Guo, X., & Wu, Z. (2021) · BMC Cardiovascular Disorders · doi:10.1186/s12872-021-02268-z · Cited by 9 · see citing works
Effects of multimodal low-opioid anesthesia protocol during on-pump coronary artery bypass grafting: a prospective cohort study
Maruniak, S. R., Oleh, L., Druzhyna, О. М., & Swol, J. (2023) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-023-02395-y · Cited by 9 · see citing works
“The sample size was calculated based on the frequency of occurrence of LCOS, which was taken at 5% [11].”
Method
Management of Post-cardiotomy Shock
Hall, E. J., Papolos, A., Miller, P. E., Barnett, C. F., & Kenigsberg, B. B. (2024) · US Cardiology Review · doi:10.15420/usc.2024.16 · Cited by 9 · see citing works
“31,32 The commonly used Society of Thoracic Surgery (STS) and European System for Cardiac Operative Risk Evaluation (EuroSCORE-2) scores do not directly predict the frequency of PCCS. 34 PCCS can develop intraoperatively, resulting in difficulty separating from cardiopulmonary bypass, or…”
Method
Natriuretic Peptides in Cardiac Anesthesia and Intensive Care
Krichevskiy, L. А., & Ia, K. (2018) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2018.08.019 · Cited by 8 · see citing works
Predictors of Increased Length of Hospital Stay in Patients with Severe Cardiomyopathy Undergoing Coronary Artery Bypass Grafting
Yu, P., Lin, D., Catalano, M. A., Cassiere, H. A., Kohn, N. E., & Hartman, A. (2019) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2019.03.017 · Cited by 8 · see citing works
Long-term outcome of perioperative low cardiac output syndrome in cardiac surgery: 1-year results of a multicenter randomized trial
Zangrillo, A., Ломиворотов, В. В., Pisano, A., Calabró, M. G., Belletti, A., Brazzi, L., Grigoryev, E. V., Guarracino, F., Monaco, F., Garofalo, E., et al. (2020) · Journal of Critical Care · doi:10.1016/j.jcrc.2020.04.005 · Cited by 8 · see citing works
Inotropes and Vasopressors Use in Critical Care and Perioperative Medicine: Evidence-Based Approach (Review)
Belletti, A., Azzolini, M. L., Baldetti, L., Landoni, G., Franco, A., & Zangrillo, A. (2022) · General Reanimatology · doi:10.15360/1813-9779-2022-5-60-77 · Cited by 8 · see citing works
Does the surgeon's experience have an impact on outcome after total arterial revascularization with composite T-grafts? A risk factor analysis
Umminger, J., Reitz, M., Rojas, S. V., Stiefel, P., Shrestha, M. L., Haverich, A., Ismail, I., & Martens, A. (2016) · Interactive Cardiovascular and Thoracic Surgery · doi:10.1093/icvts/ivw207 · Cited by 8 · see citing works
“In our risk factor analysis, a reduced preoperative LV-EF could not be identified as an independent predictor of postoperative cardiac failure, despite explicit data depicting a correlation [19, 20].”
Background
On-Pump Coronary Artery Bypass Graft: The State of the Art.
Cuminetti, G., Bonadei, I., Vizzardi, E., Sciatti, E., & Lorusso, R. (2019) · Reviews on recent clinical trials · doi:10.2174/1574887114666190301142114 · Cited by 8 · see citing works
Coronary Artery Bypass Grafting
Al‐Atassi, T., Toeg, H. D., Chan, V., & Ruel, M. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-24126-7.00088-0 · Cited by 8 · see citing works
Serum FGF21 Levels Predict the MACE in Patients With Myocardial Infarction After Coronary Artery Bypass Graft Surgery
Xie, W., Li, D., Shi, Y., Ning, Y., Yan, Y., Zhang, Y., Yu, Q., Li, Y., Du, J., Lin, Z., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.850517 · Cited by 7 · see citing works
Analysis of P(v-a)CO2/C(a-v)O2 Ratio and Other Perfusion Markers in a Population of 98 Pediatric Patients Undergoing Cardiac Surgery
Taiana, M., Tomasella, I., Russo, A., Lerose, A., Graziadei, M. C., Corubolo, L., Rama, J., Schweiger, V., Vignola, A., Polati, E., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12175700 · Cited by 5 · see citing works
“Moreover, the choice of anticoagulation strategy during CPB or ECMO support could also play a role in defining the severity of hypoperfusion, affecting the development of complications.”
Influential
Risk model for deaths and renal replacement therapy dependence in patients with acute kidney injury after cardiac surgery.
Sun, S.-R., Ma, F., Li, Q., Bai, M., Li, Y.-P., Yu, Y., Huang, C., Wang, H.-M., & Ning, X.-X. (2017) · Interactive Cardiovascular and Thoracic Surgery · doi:10.1093/icvts/ivx210 · Cited by 6 · see citing works
Redo coronary artery bypass grafting: when and how
Yang, B. K., Koprivanac, M. J., & Bakaeen, F. G. (2024) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000001169 · Cited by 5 · see citing works
Vasodilatory Shock in the ICU: Perils, Pitfalls and Therapeutic Options
Vallabhajosyula, S., Jentzer, J. C., & Khanna, A. K. (2018) · Annual update in intensive care and emergency medicine · doi:10.1007/978-3-319-73670-9_9 · Cited by 5 · see citing works
Short-term multiscale complexity analysis of cardiovascular variability improves low cardiac output syndrome risk stratification after coronary artery bypass grafting
Bari, V., Vaini, E., Pistuddi, V., Fantinato, A., Cairo, B., MARIA, B. D., Ranucci, M., & Porta, A. (2019) · Physiological Measurement · doi:10.1088/1361-6579/ab12f0 · Cited by 5 · see citing works
Characteristics, morbidity and mortality factors associated with Intra-Aortic Balloon Pump in Coronary Artery Bypass Graft Surgery patients
Shah, S. M. A., Jan, A., Awan, N. I., & Rehman, M. U. (2020) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.36.6.2649 · Cited by 6 · see citing works
Índice de cardioplejía infundida: una nueva herramienta en la protección miocárdica. Un estudio de cohortes
Rivera, J. J. J., Jorge, C. L., Sarrías, J. L. I., Martín, M. B., Almeida, J. L., Vela, J. L. P., Pinto, R. A., Hernández, R., de la Rosa, S. R., Bowden, G. Y., et al. (2018) · Medicina Intensiva · doi:10.1016/j.medin.2018.03.011 · Cited by 5 · see citing works
“IV 15 (6,1) Estado crítico preoperatorio, n (%) 0 (0) SYNTAX score, n (%)”
BackgroundInfluential
Perioperative use of levosimendan in patients undergoing cardiac surgery
Oliveros, H., García, H., Ramos, C. R., & Navarrete‐Navarro, J. (2019) · Colombian Journal of Anesthesiology · doi:10.1097/cj9.0000000000000121 · Cited by 5 · see citing works
The relationship between pre-operative right ventricular longitudinal strain and low-cardiac-output syndrome after surgical aortic valve replacement
Zhang, Y., Chen, H., Dong, Y.-L., Shang, J.-N., Ruan, L., Yang, Y., & Song, Y. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1067984 · Cited by 4 · see citing works
Risk factors for decreased cardiac output after coronary artery bypass grafting: a prospective cohort study
dos Santos, E. R., Lopes, C. T., Maria, V. L. R., & de Barros, A. L. B. L. (2016) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515116681373 · Cited by 5 · see citing works
Infused cardioplegia index: A new tool to improve myocardial protection. A cohort study
Rivera, J. J. J., Jorge, C. L., Sarrías, J. L. I., Martín, M. B., Almeida, J. L., Vela, J. L. P., Pinto, R. A., Hernández, R., de la Rosa, S. R., Bowden, G. Y., et al. (2019) · Medicina Intensiva (English Edition) · doi:10.1016/j.medine.2019.05.007 · Cited by 4 · see citing works
Time-Varying Clearance in Milrinone Pharmacokinetics from Premature Neonates to Adolescents
O’Hanlon, C. J., Sumpter, A. L., Anderson, B. J., & Hannam, J. A. (2024) · Clinical Pharmacokinetics · doi:10.1007/s40262-024-01372-5 · Cited by 4 · see citing works
“Mortality of patients who develop LCOS can exceed 20% [2] and so management of this low output state using pharmacological intervention may be required to reduce mortality.”
Using Soluble ST2 to Predict Adverse Postoperative Outcomes in Patients with Impaired Left Ventricular Function Undergoing Coronary Bypass Surgery
Dolapoğlu, A., Avcı, E., Yıldırım, T., Kadı, H., & Çelik, A. (2019) · Medicina · doi:10.3390/medicina55090572 · Cited by 4 · see citing works
“Impaired left ventricular function has been cited as a risk factor for mortality and complications after cardiac surgery [9].”
Background
Individualisierter Einsatz von Levosimendan in der Herzchirurgie
Woehrle, T., Mehringer, L., Juchem, G., Dashkevich, A., Weis, M., Schünemann, M., & Kilger, E. (2020) · Der Anaesthesist · doi:10.1007/s00101-020-00860-0 · Cited by 4 · see citing works
Management of Ischemic Heart Disease in Patients With Heart Failure
Mielniczuk, L. M., Ahmad, T., Borovac, J. A., Brown, K., Cooper, L. B., Fida, N., Hochman, J. S., Al-Lamee, R. K., Lawton, J. S., Narang, N., et al. (2025) · JACC Heart Failure · doi:10.1016/j.jchf.2025.102731 · Cited by 3 · see citing works
Predictors of cardiogenic shock in cardiac surgery patients receiving intra-aortic balloon pumps
Iyengar, A., Kwon, O. J., Bailey, K. L., Ashfaq, A., Abdelkarim, A., Shemin, R. J., & Benharash, P. (2018) · Surgery · doi:10.1016/j.surg.2017.11.021 · Cited by 3 · see citing works
Comparison of vasoactive-inotropic score, vasoactive-ventilation-renal score, and modified vasoactive-ventilation-renal score for predicting the poor prognosis after coronary artery bypass grafting
Du, Y., Li, W. Q., Chen, Q., Shi, H., Li, Q., Zhang, C., Zhuang, Y., Li, J., & Tang, L. (2023) · BMC Cardiovascular Disorders · doi:10.1186/s12872-023-03313-9 · Cited by 3 · see citing works
“Abbreviations CABG Coronary artery bypass grafting CAD Coronary artery disease VIS Vasoactive-inotropic score VVR Vasoactive-ventilation-renal Ccr Creatinine clearance VI Ventilation index LCOS Low cardiac output syndrome BMI Body mass index LVEF Left ventricular ejection fraction SinoSCORE Sino System for Coronary Op…”
BackgroundInfluential
Continuous Monitoring of Regional Function by a Miniaturized Ultrasound Transducer Allows Early Quantification of Low-Grade Myocardial Ischemia
Hyler, S., Pischke, S. E., Halvorsen, P. S., Espinoza, A. W., Bergsland, J., Tønnessen, T. I., Fosse, E. T., & Skulstad, H. (2015) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2014.12.014 · Cited by 3 · see citing works
Preservation of renal function in cardiac surgery patients with low cardiac output syndrome: levosimendan vs beta agonists
Orriach, J. L. G. (2019) · http://isrctn.com/ · doi:10.1186/isrctn46058317 · Cited by 3 · see citing works
Analysis of P(v-a)CO2/C(a-v)O2 Ratio and Other Perfusion Markers in a Population of 98 Pediatric Patients Undergoing Cardiac Surgery
Taiana, M., Tomasella, I., Russo, A., Lerose, A., Graziadei, M. C., Corubolo, L., Rama, J., Schweiger, V., Vignola, A., Polati, E., et al. (2023) · doi:10.20944/preprints202308.1985.v1 · Cited by 6 · see citing works
Postcardiotomy extracorporeal membrane oxygenation in patients older than 70 years: Characteristics, outcomes, and variables associated with mortality
Makhoul, M., Mariani, S., van Bussel, B. C. T., Wiedemann, D., Saeed, D., Mauro, M. D., Pozzi, M., Botta, L., Boeken, U., Samalavicius, R. S., et al. (2025) · JTCVS Open · doi:10.1016/j.xjon.2025.04.004 · Cited by 2 · see citing works
Delayed Sternal Closure in Heart Surgery: Outcomes and Quality of Life
Heuer, H., Song, Z., Hegner, P., Truong, A., Wiesner, S., Terrazas, A., Larisch, C., Aigner, H., Floerchinger, B., Schmid, C., et al. (2025) · The Thoracic and Cardiovascular Surgeon · doi:10.1055/a-2607-6390 · Cited by 2 · see citing works
“22 In patients with bleeding-related indications, the 30-day mortality rates were consistent with the literature.”
Intraoperative global longitudinal strain and strain rate as predictors of unfavorable outcome following on-pump mitral surgery: a prospective observational study
Monaco, F., Bonaccorso, A., Ursoleo, J. D., Pruna, A., Lerose, C. C., Prima, A. L. D., Barucco, G., Landoni, G., Licheri, M., & Mit-Go Study Group Collaborators (2025) · Journal of Anesthesia Analgesia and Critical Care · doi:10.1186/s44158-025-00288-1 · Cited by 2 · see citing works
“Low cardiac output syndrome (LCOS) is a major concern following cardiac surgery with the use of cardio-pulmonary bypass (CPB) [1] and is characterized by a decline in cardiac output resulting in systemic hypoperfusion and inadequate oxygen delivery [2].”
Influential
Design and rationale of the Impella®-protected cardiac surgery trial (IMPACT): A multicenter, single-arm pilot study in high-risk cardiac surgery patients
Goldstein, D. J., Reichenspurner, H. C., Vorovich, E., Teuteberg, J. J., Ramzy, D., Lobdell, K. W., Parks, R. J., May, A. G., Aggarwal, S., & Soltesz, E. G. (2026) · American Heart Journal · doi:10.1016/j.ahj.2026.107434 · Cited by 2 · see citing works
Anisocytosis as a possible predictor of low cardiac output syndrome in children undergoing mitral valve surgery
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Predictors of Low Cardiac Output Syndrome After Isolated Coronary Artery Bypass Grafting
Ding, W., Ji, Q., Shi, Y., & Ma, R. (2015) · International Heart Journal · doi:10.1536/ihj.14-231 · Cited by 77 · see citing works
Frequency of Low Cardiac Output Syndrome Following on Pump Coronary Artery Bypass Grafting Surgery and it’s Association with Degree of Pre-operative Left Ventricular Dysfunction
Rana, K., Ansari, A., Sharma, P. K., Yadav, L., & Shahbaz, A. (2023) · Kathmandu University Medical Journal · doi:10.3126/kumj.v21i1.80579 · Cited by 5 · see citing works
Predictors of low cardiac output syndrome after coronary artery bypass
Rao, V., Ivanov, J., Weisel, R. D., Ikonomidis, J. S., Christakis, G. T., & David, T. E. (1996) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(96)70176-9 · Cited by 286 · see citing works
Association of Low Cardiac Output Syndrome with in Hospital Outcomes after on Pump Coronary Artery Bypass Grafting Surgery
Farogh, A., Hasan, A., Naz, F., George, J., Emmanuel, S., & Farhana, A. (2022) · doi:10.53350/pjmhs221610221
Risk factors for low cardiac output syndrome after coronary artery bypass grafting surgery
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Authors: Algarni, K. D., Maganti, M., & Yau, T. M.
Affiliations: University of Toronto (CA)
Corresponding author: Yau, Terrence M.
ORCID: Algarni, Khaled D.
Yau, Terrence M.
Venue: The Annals of Thoracic Surgery
Publisher: Elsevier BV
Published: 2011-11
Volume: 92
Issue: 5
Pages: 1678-1684
ISSN: 0003-4975 (ISSN-L)
DOI: 10.1016/j.athoracsur.2011.06.017
OpenAlex: W2153407613
Cited by: 152
References: 22
Citations by year: 2026: 8 · 2025: 12 · 2024: 7 · 2023: 15 · 2022: 9 · 2021: 10 · 2020: 16 · 2019: 17 · 2018: 17 · 2017: 12 · 2016: 10 · 2015: 9 · 2014: 2 · 2013: 4 · 2012: 2
FWCI: 2.94
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The Annals of Thoracic Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Physical Sciences › Engineering › Biomedical Engineering › Mechanical Circulatory Support Devices
Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Keywords: low cardiac output syndrome, coronary artery bypass grafting, left ventricular ejection fraction, left ventricular dysfunction, cardiogenic shock, emergency surgery, risk factors, temporal trends, preoperative assessment, cardioprotection, circulatory support
MeSH terms: Aged, Coronary Artery Bypass, Cardiac Output, Low, Female, Humans, Male, Prospective Studies, Time Factors, Prevalence

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Predictors of low cardiac output syndrome after isolated coronary artery bypass surgery: trends over 20 years

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