Evaluating the Prevalence of Cardiac Surgery–associated Acute Kidney Injury After Septal Myectomy Combined With Concomitant Procedures in Obstructive Hypertrophic Cardiomyopathy

Hypertrophic obstructive cardiomyopathy (HOCM) may be treated by septal myectomy. Cardiac surgery–associated acute kidney injury (CSA-AKI) is a common complication, but little is known about its incidence after septal myectomy. The objectives of this work were to evaluate the prevalence of CSA-AKI a...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2024-10, Vol.38 (10), p.2254-2260
Main Authors: de Wijs, Calvin J., Schoonvelde, Stephan A.C., Mik, Egbert G., de Jong, Peter L., Michels, Michelle, Harms, Floor A.
Format: Article
Language:English
Subjects:
acute kidney injury
beta-blockers
cardiac surgery
hypertrophic cardiomyopathy
myectomy
perioperative risk
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Summary:Hypertrophic obstructive cardiomyopathy (HOCM) may be treated by septal myectomy. Cardiac surgery–associated acute kidney injury (CSA-AKI) is a common complication, but little is known about its incidence after septal myectomy. The objectives of this work were to evaluate the prevalence of CSA-AKI after septal myectomy and identify potential perioperative and phenotype-related factors contributing to CSA-AKI. This was a retrospective database analysis with new data analysis. The study occurred in a single university academic expertise center for septal myectomy HOCM patients. Data from 238 HOCM patients with septal myectomy operated on between 2005 and 2022 were collected. CSA-AKI was stratified according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines using measurement of creatinine and urine production. Important HOCM phenotype-related and perioperative factors were analyzed for their possible associations with CSA-AKI. CSA-AKI occurred in 45% of patients; of these, 55% were classified as KDIGO stage I and the remaining 45% as stage II, with no chronic kidney damage observed. Moreover, there were no phenotypical or perioperative characteristics that were more prevalent in the CSA-AKI cohort. However, the use of beta-blockers and coronary artery disease were more prevalent in the CSA-AKI cohort. CSA-AKI is a common complication after septal myectomy but was transient, and kidney function recovered in all patients.
ISSN:1053-0770
1532-8422
1532-8422
DOI:10.1053/j.jvca.2024.05.038