EFFECTIVENESS OF MAXIMUM FUNCTIONAL CAPACITY AS AN ASSESSMENT TOOL FOR PREOPERATIVE ASSESSMENT FOR CARDIAC SURGERY: AN INITIAL ANALYSIS

Abstract

Objective: To evaluate the value of VO2 max testing in the preoperative assessment of patients undergoing elective cardiac surgery. To investigate whether poor preoperative cardiopulmonary reserve and comorbid state dictate high risk status and predict complications in patients undergoing elective cardiac surgery.

Study Design: Descriptive cross sectional study.

Place and Duration of Study: AFIC/NIHD Rawalpindi Pakistan, from 2016 to 2017.

Material and Methods: Total number of 44 adult patients undergoing coronary artery bypass graft surgery (CABG) requiring cardiopulmonary bypass (CPB), having an EF of >45% were recruited in the study as per inclusion criteria through nonrandom consecutive sampling.

Results: We analyzed the data of 39 eligible patients (Male 35 (89.7%), Female 4 (10.3%)). Mean age of our study population was 55.0 ± 10.2 years and a mean BMI of 26.8 ± 3.81. There were 20 (54.1%) hypertensives, 2(5.4%) diabetics and 5 (13.5%) smokers. There was only one patient with a history of previous myocardial infarction (MI). Majority of the patients belonged to NYHA class II 30 (76.9%) with a mean EF of 56.6 ± 5.17. Prolonged
ventilation (>24 hrs) was significantly associated with lesser values of VO2max with a p-value of 0.01.Similarly, post-operative prolonged BiPAP usage (>50hrs) was reported more in group I as compared to other groups. The incidence of postoperative pulmonary complications was significantly associated with lower values of VO2 max with a p-value=0.039.

Conclusion: We conclude from this study that VO2 max levels are correlated with postoperative outcome. Patients with cardiopulmonary fitness below the recommended cut-points are susceptible to postoperative complications and mortality.