Preoperative Right Ventricular Echocardiographic Parameters Predict Perioperative Cardiovascular Complications in Patients Undergoing High risk Non-Cardiac Surgery

Background: Every year, 200 million people worldwide have major non-cardiac surgery (NCS), and 10 million people experience a significant cardiac problem during the first 30 days following NCS. Perioperative cardiovascular complications (PCCs), are extremely significant since they contribute to at least one-third of perioperative mortality, lengthen hospital stays, and raise medical expenses. Objective: To investigate the importance of presurgical right ventricular echocardiographic parameters in the prediction of PCCs in individuals having high-risk NCS. Methods: In this prospective cohort observational trial, 200 patients who were all potential candidates for high-risk, non-cardiac operations between October 2020 and June 2021 were included. Patients were submitted preoperatively into one group and post operatively into two groups according to presence of postoperative cardiac complications Results: The incidence of PPCs among the study population was about 36 patients of 200 patients with percentage of 18%. The results also revealed that significant predictors of postoperative PCCs after major NCS arranged by descending manner according to their odds ratio as following: Tie index >0.47, TV E/A ≤1.18, TAPSE ≤1.8, MV E/A ≤1.3, LVEF (%) ≤56, LVESDV (ml3) >35.6, HbA1C >7.7 MV E/e- >8.32, Revised cardiac risk index, RV FAC (%) ≤35.6, MR up to Mod, S creat (mg/dL) >1.4, LAVI >22, S urea (mg/dL) >34. By multivariate analysis we found that the significant risk factors for PCCs are LVEF (%) ≤56, TV E/A ≤1.18, and Tie index >0.47. Conclusion: Right ventricular echocardiographic measures taken prior to surgery are independent risk factors for PCCs in individuals having major NCS.