Virtual Conference
Heart 2022 Conference

Amanda Bergamo Mazetto

Instituto do Coração do hospital das Clínicas de São Paulo, Brazil

Title: Perioperative mortality difference between cardiovascular procedures in patients with aortic stenosis with reduced ejection fraction or borderline and preserved ejection fraction


Introduction: Despite improvement in medical therapy and surgical techniques, management of patients with reduced ejection fraction submitted to cardiac surgery is still challenging. It’s well known that patients with low ejection fraction have a higher incidence of comorbidity and has been shown to be an independent predictor of higher perioperative mortality. In this study, our aim is to show data about patients with aortic stenosis submitted to vascular and/or cardiac procedures and their mortality rate in case of low ejection fraction (< 40%) or borderline (41-49%) and preserved ejection fraction (> 50%). This differentiation is crucial to be extremely careful with patients who represent high risk of mortality if submitted to a cardiac or vascular procedure.

Methods: A longitudinal, retrospective study was made in a tertiary center, with 12.767 patients with diagnosis of aortic stenosis that were submitted to surgical procedures, in majority cardiac or vascular. In a cohort of 12.767 a number of 115 patients did not have their ejection fraction documented, as well as their procedure, or were submitted to different procedures that were not cardiac or vascular, so these were excluded from the study.

Results: A number of 11.819 patients submitted to cardiac or vascular surgery with borderline or preserved EF were submitted, and 1266 died, representing a mortality rate of 10,71%.
947 patients were submitted to cardiac or vascular surgery with reduced ejection fraction, and 275 died, representing a mortality rate of 29,03%.

Conclusion: In patients with aortic stenosis and reduced ejection fraction, the mortality is 2,71 times higher than borderline and preserved ejection fraction when submitted to a cardiovascular procedure. That information needs to be considered when a surgery is indicated and these patients have to receive special attention in preoperative assessment and management for improving the outcomes.


Amanda Mazetto is a medical student and researcher in the field of Cardiology in Brazil.