Does mildly impaired LVEF (55%-60%) and significant LV dilation increase the risk of unplanned readmission in adult patients undergoing aortic regurgitation surgery?
In patients undergoing surgery for aortic regurgitation, mildly impaired LVEF (55%-60%) combined with significant LV dilation (LVEDD > 65 mm) identifies a high-risk cohort for unplanned postoperative readmission.
Background and objective Aortic regurgitation (AR) is a common valvular heart disease. Despite advances in surgical techniques, unplanned readmission rates after surgery remain high. This study aimed to investigate the risk of postoperative unplanned readmission in patients with only mildly impaired left ventricular ejection fraction (LVEF 55%–60%) but concomitant left ventricular enlargement. Methods This single-center retrospective cohort study enrolled 841 adult patients diagnosed with aortic regurgitation who underwent surgical treatment at our hospital between January 2020 and December 2024. All patients underwent transthoracic echocardiography (TTE) within 3 days before surgery. The primary endpoint event was unplanned readmission during postoperative follow-up. Results During follow-up, 46 patients experienced unplanned readmission. Risk factor analysis for readmission indicated that patients in the LVEF 55%–60% group had significantly higher risk of postoperative readmission HR (95% CI): 4.118 (1.488–11.397), P = 0.006. Further Cox proportional hazards regression analysis revealed that LVEDD 65 mm and LVEF 60% were significant risk factors for unplanned readmission during postoperative follow-up ( P 0.05). Among all patients with unplanned readmissions, 21 cases had both LVEDD 65 mm and LVEF 60%, of whom 12 patients (57.14%) had an LVEF of 55%–60%. Cox regression analysis showed that patients meeting both risk factors had a significantly higher risk of unplanned readmission compared to those with neither risk factor HR (95% CI): 2.548 (1.174–5.534), P = 0.018. Conclusion Patients with mildly impaired left ventricular ejection fraction (LVEF 55%–60%) combined with significant left ventricular dilation (LVEDD 65 mm) constitute a high-risk cohort for unplanned readmission postoperatively. For patients with aortic regurgitation, even those exhibiting only mildly impaired LVEF, coexisting significant left ventricular dilation warrants heightened vigilance regarding readmission risk.
Li et al. (Tue,) studied this question.