Study Population
This study was a retrospective analysis from a single academic
institution. Data were extracted from the institutional Society of
Thoracic Surgeons (STS) registry and supplemented with longitudinal
clinical data extracted from the electronic health record. The study
included adults (18 years or older) presenting in a state of cardiogenic
shock that underwent conventional cardiac surgery between January 2010
and May 2020. Cardiogenic shock was defined according to the STS
database as a sustained (>30 minute) episode of
hypoperfusion evidenced by systolic blood pressure <90mmHg
and/or, if available, cardiac index <2.2 L/min per square
meter determined to be secondary to cardiac dysfunction and/or the
requirement for parenteral inotropic or vasopressor agents or mechanical
support to maintain blood pressure and cardiac index above those
specified levels.
Patients undergoing transcatheter procedures such as transcatheter
mitral or aortic valve repair or replacement, were excluded. Patients
who underwent primary ventricular assist device (VAD) placement and/or
heart transplantation were also excluded. This study was approved by the
Institutional Review Board at the University of Pittsburgh.