Key result
Cardiopulmonary bypass duration >2 hours was associated with an 18.13-fold increased risk of early postoperative major adverse cardiovascular events compared to duration ≤2 hours in patients with SVAS.
Why the study?
Patients undergoing surgical repair of supravalvular aortic stenosis are at high risk for postoperative MACE, but the association between cardiopulmonary bypass duration and early MACE was not fully clarified.
Does cardiopulmonary bypass duration >2 hours increase the risk of early major adverse cardiovascular events in pediatric patients undergoing surgical repair of supravalvular aortic stenosis?
Cohort (n=297)
Yes
Does cardiopulmonary bypass duration >2 hours increase the risk of early major adverse cardiovascular events in pediatric patients undergoing surgical repair of supravalvular aortic stenosis?
Odds Ratio: 18.13 (95% CI 2.33–140.86)
p-value: p=0.006
Cardiopulmonary bypass duration exceeding 2 hours during surgical repair of supravalvular aortic stenosis is independently associated with a significantly increased risk of early postoperative major adverse cardiovascular events.
Supports minimizing bypass time in SVAS repair where feasible; hypothesis-generating and requires prospective confirmation before practice change.
Background: Patients who underwent surgical repair of supravalvular aortic stenosis (SVAS) are at high risk for postoperative major adverse cardiovascular events (MACE). This study aimed to investigate the association between cardiopulmonary bypass (CPB) duration and MACE occurring during postoperative hospitalization or within 30 days post-surgery. Methods: Patients who underwent surgical repair of SVAS from 2002 to 2019 at Beijing Fuwai Hospital and Yunnan Fuwai Hospital were included in this study. Patients were stratified into "CPB duration >2 h" and "CPB duration ≤2 h" groups based on intraoperative CPB duration. Various statistical methodologies were employed to investigate the association between CPB duration and early postoperative MACE, including multivariate adjustment, propensity score adjustment, propensity score matching, and logistic regression based on propensity score weighting. Results: = 0.006). Consistent results were obtained in the Inverse probability of treatment-weighted, standardized mortality ratio-weighted, pairwise algorithmic-weighted, and overlap-weighted models. Conclusion: Patients with CPB duration >2 h were at a higher risk of early postoperative MACE compared to those with CPB duration ≤2 h. This emphasized the significance of minimizing CPB exposure for the prognosis of patients with SVAS.
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Peng et al. (2025) conducted a cohort in Supravalvular aortic stenosis (n=297). Cardiopulmonary bypass duration >2 hours vs. Cardiopulmonary bypass duration ≤2 hours was evaluated on Early major adverse cardiovascular events (MACE) (OR 18.13, 95% CI 2.33-140.86, p=0.006). Cardiopulmonary bypass duration >2 hours was associated with an 18.13-fold increased risk of early postoperative major adverse cardiovascular events compared to duration ≤2 hours in patients with SVAS.
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