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.