Outcome in patients with diabetes mellitus undergoing isolated surgical aortic valve replacement

Abstract

Background: The risk scoring systems used in cardiac surgery (including EuroSCORE II) include only insulin-dependent diabetes. Diabetes mellitus (DM) is a marker of poor prognosis after surgical myocardial revascularization, but its impact in patients with isolated surgical aortic valve replacement (SAVR) has not been well established. Aim: We aimed to analyze differences in outcomes and surgical risk in patients with and without type 2 DM (T2DM), which underwent SAVR. Material and methods: We included retrospectively the patients hospitalized for SAVR between January 2000 and June 2014 in Cardiovascular Surgery Unit of Cardiovascular Diseases Institute. Preoperative parameters and early postoperative outcome in patients with and without T2DM were compared. Results: A number of 1191 patients were included (65.4±13 years; 67.8% men); 144 (12.07%) out of those were with T2DM. Biological prostheses were performed in 22% of patients. Mean age was higher in T2DM group (p=0.005). The mean EuroSCORE II risk score was 5.49±0.63 in T2DM and 4.89±0.17 in non-T2DM patients (p=0.579). In these 2 groups, preoperative left ventricular systolic function was comparable. Mean values of cardiopulmonary bypass time were 137.88±5.71 minutes in T2DM, 149.48±4.8 minutes in non-T2DM patients (p=0.714). The need of inotropic therapy was an important predictor for postoperative evolution (6±2 days in non-T2DM and 15±4 days in T2DM; p=0.008). Conclusions: Patients with T2DM undergoing SAVR have a nonsignificantly higher operative risk score comparing with non-T2DM patients. In spite of this, T2DM seems to be a risk factor that could worsen the postoperative outcome, by requiring prolonged inotropic treatment.