Cited by 143Cardiac Valve Diseases and TreatmentsAortic Disease and Treatment ApproachesCardiac and Coronary Surgery Techniques

The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.

Predictors of Low Cardiac Output Syndrome After Isolated Aortic Valve Surgery

Open access

Maganti, Manjula D., Rao, Vivek, Borger, Michael A., Ivanov, Joan, David, Tirone E.·2005·Circulation

DOI 10.1161/circulationaha.104.526087

Open this paper in CoChat — free account Open PDF

Abstract

BACKGROUND: Low cardiac output syndrome (LCOS), defined as the need for postoperative intraaortic balloon pump or inotropic support for >30 minutes in the intensive care unit, remains a relatively common complication of aortic valve (AV) surgery. The aim of this study is to identify the preoperative predictors of LCOS in patients undergoing isolated AV surgery. METHODS AND RESULTS: We conducted a retrospective review of data prospectively entered into an institutional database. Between 1990 and 2003, 2255 patients underwent isolated AV surgery with no other concomitant cardiac surgery. The independent predictors of LCOS and operative mortality (OM) were determined by stepwise logistic regression analysis. The overall prevalence of LCOS was 3.9%. The independent predictors of LCOS were (odds ratio in parentheses) renal failure (5.0), earlier year of operation (4.4), left ventricular ejection fraction <40% (3.6), shock (3.2), female gender (2.8), and increasing age (1.02). Overall OM was 2.9%. The OM was higher in patients who experienced LCOS (38% versus 1.5%; P<0.001). The independent predictors of mortality were (odds ratio in parentheses) preoperative renal failure (8.3), urgency of surgery (3.4), previous stroke (2.9), congestive heart failure (2.6), previous cardiac surgery (2.3), hypertension (1.7), and small AV size (1.3). CONCLUSIONS: Low-output syndrome is associated with significantly increased morbidity and mortality. Novel strategies to preserve renal function, optimization of preexisting heart failure symptoms, and avoidance of prosthesis-patient mismatch may reduce the incidence of LCOS and lead to improved results after AV surgery.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1161/circulationaha.104.526087

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The meaning and use of the area under a receiver operating characteristic (ROC) curve.
Hanley, J. A., & McNeil, B. J. (1982) · Radiology · doi:10.1148/radiology.143.1.7063747 · Cited by 21,856
A method of comparing the areas under receiver operating characteristic curves derived from the same cases
Hanley, J. A., & McNeil, B. J. (1983) · Radiology · doi:10.1148/radiology.148.3.6878708 · Cited by 7,016
Best Subsets Logistic Regression
Hosmer, D. W., Jovanovic, B. D., & Lemeshow, S. A. (1989) · Biometrics · doi:10.2307/2531779 · Cited by 1,175
Impact of Valve Prosthesis-Patient Mismatch on Short-Term Mortality After Aortic Valve Replacement
Blais, C., Dumesnil, J. G., Baillot, R. G., Simard, S., Doyle, D., & Pîbarot, P. (2003) · Circulation · doi:10.1161/01.cir.0000085167.67105.32 · Cited by 564
Prosthesis-Patient Mismatch Affects Survival After Aortic Valve Replacement
Rao, V., Jamieson, W. R. E., Ivanov, J., Armstrong, S., & David, T. E. (2000) · Circulation · doi:10.1161/01.cir.102.suppl_3.iii-5 · Cited by 332
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
The influence of gender on the outcome of coronary artery bypass surgery
Abramov, D., Tamariz, M. G., Sever, J. Y., Christakis, G. T., Bhatnagar, G., Heenan, A. L., Goldman, B. S., & Fremes, S. E. (2000) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(00)01563-0 · Cited by 227
Impact of prosthesis-patient mismatch on hemodynamic and symptomatic status, morbidity and mortality after aortic valve replacement with a bioprosthetic heart valve.
Pîbarot, P., Dumesnil, J. G., Lemieux, M. D., Cartier, P. C., Métras, J., & Durand, L. (1998) · PubMed · Cited by 201
Long-Term Survival of Dialysis Patients in the United States With Prosthetic Heart Valves
Herzog, C. A., Ma, J. Z., & Collins, A. J. (2002) · Circulation · doi:10.1161/hc1102.100075 · Cited by 193
Is body size the cause for poor outcomes of coronary artery bypass operations in women?
Christakis, G. T., Weisel, R. D., Buth, K. J., Fremes, S. E., Rao, V., Panagiotopoulos, K. P., Ivanov, J., Goldman, B. S., & David, T. E. (1995) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(95)70058-7 · Cited by 125

Flagged first, then by citations

Show all 22 references

Research works printed but not linked: 3

10.1161/circ.94.1.113 · DOI
10.1161/circ.105.11.1336 · DOI
10.1161/circ.102.1.5 · DOI

Sorted by citations

Items 101–143 of 143

Predictors of Outcome in Patients with Pulmonary Hypertension Undergoing Mitral and Tricuspid Valve Surgery
Kew, E. P., Caruso, V., Grapsa, J., Bosco, P., & Lucchese, G. (2023) · Medicina · doi:10.3390/medicina59061103 · Cited by 2
“Patients with impaired LV function are more susceptible to low cardiac output state post-op and require inotropic support [18]; hence, they are more at risk of end organ failure such as respiratory and renal failure [19].”
Background
Complications of Coronary Artery Bypass Grafting Surgery
Khorsandi, M., Shaikhrezai, K., & Zamvar, V. (2014) · Springer eBooks · doi:10.1007/978-3-642-37393-0_233-2 · Cited by 2
“2 L/min per square meter (Rao et al. 1996; Maganti et al. 2005).”
Problems Related to Redo Cardiac Surgery
Machiraju, V. R. (2011) · Springer eBooks · doi:10.1007/978-1-4614-1326-4_1 · Cited by 2
Specified risk prediction is what we need in cardiac surgical patients
Arslan, Y., Yilmaz, M. E., & Kehlіbar, T. (2010) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/j.ejcts.2010.09.004 · Cited by 2
“The effect of LCOS in a valvular population is more dramatic than that reported in patients undergoing isolated coronary artery bypass grafting (CABG) [2].”
Background
Effect of aprotinin on renal dysfunction
Mirakaj, V., Schmid, E., & Rosenberger, P. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60981-2 · Cited by 2
NT-proBNP as a marker of postoperative heart failure in adult cardiac surgery
Jiang, H. (2019) · Linköping University medical dissertations · doi:10.3384/diss.diva-161324 · Cited by 1
Optimal Inotropic Support Strategy in Low Cardiac Output Syndrome
Miles, T. J., Blackburn, K. W., Moon, M. R., & Chatterjee, S. (2025) · Seminars in Thoracic and Cardiovascular Surgery · doi:10.1053/j.semtcvs.2025.04.002 · Cited by 1
ECMO for Postcardiotomic Shock
Baiocchi, M., Caramelli, F., & Frascaroli, G. (2014) · Springer eBooks · doi:10.1007/978-88-470-5427-1_11 · Cited by 1
“Several preoperative risk factors of LCOS have been identifi ed both in coronary and in valve surgery [ 3 , 28 ].”
Background
Mitochondrial ATP Synthase Tetramer Disassembly following Blood-Based or del Nido Cardioplegia during Neonatal Cardiac Surgery.
Simon, B. V., Beutner, G., Swartz, M. F., Angona, R. E., Smith, K., Porter, G. A., Jr., & Alfieris, G. M. (2022) · PubMed Central · doi:10.1182/ject-203-211 · Cited by 1
The Value of Stress-Gated Blood Pool SPECT in Predicting Early Postoperative Period Complications in Ischemic Cardiomyopathy Patients: Focus on Mechanical Dyssynchrony
Shipulin, V. V., Andreev, S. L., Kopeva, K. V., Shipulin, V. M., & Zavadovsky, K. V. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12165328 · Cited by 1
“The primary endpoint of this study was a composite of LCOS (need for intra-aortic balloon pump (IABP) and/or inotropic support requiring more than 2 days in the intensive care unit and/or cardiac death within 30 days after surgery [16,17].”
Method
Aortokoronare Bypass- und Herzklappenoperationen
Fischer, D., & Drexler, H. (2007) · Der Internist · doi:10.1007/s00108-007-1831-z · Cited by 1
Mixed Venous Oxygen Saturation during the Transcatheter Aortic Valve Replacement—A Prospective Cohort Study
Musialowicz, T., Ellam, S., Valtola, A., Halonen, J., & Lahtinen, P. (2019) · Open Journal of Anesthesiology · doi:10.4236/ojanes.2019.97014 · Cited by 1
Complications of Coronary Artery Bypass Grafting Surgery
Khorsandi, M., Shaikhrezai, K., & Zamvar, V. (2015) · Springer eBooks · doi:10.1007/978-3-642-37078-6_233 · Cited by 1
L’ECMO en postcardiotomie
Litzler, P., Lebreton, G., & Hubscher, C. (2010) · Springer eBooks · doi:10.1007/978-2-287-99773-0_8 · Cited by 1
Effect of aprotinin on renal dysfunction
Schneeweiß, S., Walker, A. M., & Seeger, J. D. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60980-0 · Cited by 1
High-Volume Hemofiltration in Post–Cardiac Surgery Shock. A Heroic Therapy?
Palevsky, P. M. (2015) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201508-1561ed · Cited by 1
Importance of Noninvasive Cardiac Output Measurement in Children: Feasibility or Applicability?
Nasr, V. G., & Friedman, K. G. (2021) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2021.01.022 · Cited by 1
Faculty Opinions recommendation of Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality.
Slaughter, T. (2014) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.718123282.793492861 · Cited by 1
Contemporary Considerations in Aortic Valve Surgery
Atkins, B. Z., Kon, N. D., & Hughes, G. C. (2009) · Humana Press eBooks · doi:10.1007/978-1-59745-411-7_13
Predictors of poor cardiac recovery pattern after aortic declamping in consecutive cardiac surgery cases
Karmacharya, R. M., Xi-gang, G., Jianjie, G., Haichen, W., Yang, Y., & Yong-xin, L. (2013) · Nepalese Heart Journal · doi:10.3126/njh.v9i1.8341
Surgery for aortic stenosis : with special reference to myocardial metabolism, postoperative heart failure and long-term outcome
Vánky, F. B. (2006) · DiVA (Linkoping University)
The Receptor for Advanced Glycation End-Products (RAGE) and its Ligands in Systemic Inflammation following Surgery Necessitating Cardiopulmonary Bypass
Creagh-Brown, B. C. (2011) · Spiral (Imperial College London) · doi:10.25560/7057
“41 graft failure, reperfusion injury, and hypothermia [72-74].”
Background
Implications of myocardial dysfunction before and after aortic valve intervention
Hultkvist, H. (2019) · Linköping University medical dissertations · doi:10.3384/diss.diva-156719
Use of intra-aortic balloon pump in cardiac surgery: analysis of 80 consecutive cases Uso do balão intra-aórtico no trans e pós- operatório de cirurgia cardíaca: análise de 80 casos
Júnior, F. P., Tagliari, A. P., Luvizetto, A. B., Costa, E. M., Siliprandi, E. M. O., Nesralla, I. A., Pires, R., & Kalil, K. (2012)
Intraprocedural Guidance and Monitoring
Gavazzoni, M., Pozzoli, A., Miura, M., Ho, E. C., Taramasso, M., Plass, A., Haager, P. K., Rickli, H., Züber, M., & Maisano, F. (2020) · Springer eBooks · doi:10.1007/978-3-030-27584-6_4
Commentary: The high cost of low output
Eikelboom, R., & Arora, R. C. (2020) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2020.08.037
Cardiovascular Management
Bojar, R. M. (2020) · doi:10.1002/9781119582540.ch11
Cardiovascular Management
Bojar, R. M. (2010) · doi:10.1002/9781444325287.ch11
Cardiovascular System
Kratzert, W. B., & Boyd, E. (2015) · Advances in medical technologies and clinical practice book series · doi:10.4018/978-1-4666-8603-8.ch016
Complications of Coronary Artery Bypass Grafting Surgery
Khorsandi, M., Shaikhrezai, K., & Zamvar, V. (2014) · Springer eBooks · doi:10.1007/978-3-642-37393-0_233-1
Invited Commentary
Rao, V. (2010) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2010.05.003
Comparision of Cardiac Output Measured by Transthoracic Echocardiography with Continuous Cardiac Output Measured by Pressure Recording Analytical Method
Madhuri, M., Singh, N., Nagaraja, P., Pranathi, E., Shankar, C., Satish, N., Prabhakar, V., & Gupta, A. (2023) · Annals of Cardiac Anaesthesia · doi:10.4103/aca.aca_41_22
“Low cardiac output (LCO) is a common complication following cardiac surgery, leading to postoperative morbidity and mortality.[1,2] Identification of LCO is essential to ensure prompt intervention, maximize oxygen delivery (DO2), and for maintaining tissue perfusion and organ function.”
BackgroundInfluential
Low cardiac output syndrome after cardiac surgery with extracirculatory at cardiovascular center, E hospital
Trung, H. V., Trang, P. T. T., Son, D. H., & Thuy, N. T. (2023) · Tạp chí Phẫu thuật và Tim mạch và Lồng ngực Việt Nam · doi:10.47972/vjcts.v42i.901
Heart Failure Readmissions After Cardiac Surgeries
Ullah, W., Rajapreyar, I. N., & Brailovsky, Y. (2023) · JACC Advances · doi:10.1016/j.jacadv.2023.100600 · Cited by 1
Surgical Ablation of Atrial Fibrillation with Cryo and Radiofrequency Concomitant to Mitral Valve Surgery : Clinical, Biochemical and Echocardiography Outcomes
Boano, G. (2023) · Linköping University medical dissertations · doi:10.3384/9789180753784
Assessing the effectiveness of Levosimendan Use and Intra-Aortic Balloon Pump Use in Controlling Postoperative Complications in Patients Undergoing Coronary Artery Bypass Graft Surgery with Low Ejection Fraction: A Comparative Study
Samy, M., Anis, H., Amin, M., & Fayad, E.-S. A. (2025) · The Egyptian Journal of Surgery · doi:10.21608/ejsur.2024.307626.1136
“[41] to be the primary risk factor for the emergence of low cardiac output syndrome.”
Poor Sympathetic Compensation During Active Standing Increases the Risk of Morbidity–Mortality in the Post-Surgery of Patients with Severe Calcific Aortic Stenosis
Ávila‐Vanzzini, N., Santana-Ortiz, A., Sánchez-Estrada, D., Springall, R., Lerma, A., Herrera-Bello, H., Calderón‐Juárez, M., & Lerma, C. (2025) · Biology · doi:10.3390/biology14020146
“Surgery, the main form of correction of this valve disease [6], carries implicit risks of morbidity and mortality [1,7,8].”
Perioperative Hemodynamic and Hemostasis Management
Wakefield, B. J., Bauer, A. M., & Mehta, A. R. (2024) · Springer eBooks · doi:10.1007/978-3-031-65839-6_23
Triangular posterior pericardiectomy and postoperative outcomes after coronary artery bypass grafting
Imiełowski, D., Feusette, P., Tukiendorf, A., & Cisowski, M. W. (2026) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2026.1850675
“This may result in low cardiac output syndrome (LCOS) with manifestations such as hypotension, oliguria, neurological disorders including transient ischemic attack (TIA) and stroke, and the need for inotropic agents or mechanical circulatory support (22).”
Cardiopulmonary Bypass-Related Determinants of Adverse Postoperative Outcomes in Adult Cardiac Surgery: A Comprehensive Narrative Review
Jagtap, N. P., Sankannavar, S. S., Shitole, A. B., & Patil, A. P. (2026) · International Journal of Health Sciences and Research · doi:10.52403/ijhsr.20260627
Anesthésie-réanimation en chirurgie cardiaque
Denault, A. Y., Ased, H., & Lebon, J.-S. (2014) · Arnette eBooks · doi:10.3917/arne.fella.2014.01.0239
Perioperative Factors Associated with Delayed Extubation After the Ross Procedure for Aortic Regurgitation: A Retrospective Cohort Study
Chen, W., Chen, Y., Ji, B., Shen, N., Sun, J., Ma, C., Yang, M., & Yu, B. (2026) · Pediatric Cardiology · doi:10.1007/s00246-026-04490-y
Impact of Preoperative Versus Intraoperative and Postoperative Intra-Aortic Balloon Pump Insertion on Mortality and Clinical Outcomes in High-Risk Coronary Artery Bypass Grafting Patients: A Systematic Review and Meta-Analysis
Hutabarat, M. C. B. A. P., Limanto, D. H., Rizki, M., & Sembiring, Y. E. (2026) · Cor et Vasa · doi:10.33678/cor.2026.065

Authors: Maganti, M. D., Rao, V., Borger, M. A., Ivanov, J., & David, T. E.
Affiliations: University of Toronto (CA)
ORCID: Rao, Vivek
Borger, Michael A.
David, Tirone E.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-08-30
Volume: 112
Issue: 9_supplement
Pages: I448-52
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.104.526087
OpenAlex: W1495427827
Cited by: 143
References: 22
Citations by year: 2026: 4 · 2025: 3 · 2024: 4 · 2023: 19 · 2022: 8 · 2021: 5 · 2020: 12 · 2019: 11 · 2018: 3 · 2017: 8 · 2016: 3 · 2015: 7 · 2014: 9 · 2013: 7 · 2012: 9
FWCI: 2.05
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: Heart and Stroke Foundation of Canada
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords: low cardiac output syndrome, aortic valve surgery, isolated aortic valve replacement, postoperative complications, postoperative mortality, preoperative risk factors, renal failure, left ventricular ejection fraction, shock, prosthesis-patient mismatch, heart failure, intra-aortic balloon pump, inotropic support
MeSH terms: Aged, Aortic Valve, Cardiac Output, Low, Cardiotonic Agents, Critical Care, Female, Humans, Intra-Aortic Balloon Pumping, Kidney Failure, Chronic, Length of Stay, Male, Middle Aged, Postoperative Complications, Prospective Studies, Retrospective Studies, Risk Factors, Stroke Volume, Prevalence, Odds Ratio, Databases, Factual, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Predictors of Low Cardiac Output Syndrome After Isolated Aortic Valve Surgery

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks