A diagnosis of low cardiac output syndrome required the active intervention of the cardiac surgeon, and at our institution this intervention represented a failure of our usual perioperative strategy. Thus the diagnosis of low cardiac output syndrome was a reproducible clinical outcome. The Warm Heart Investigators established an independent committee to evaluate postoperative low cardiac output syndrome.2 Their criteria for diagnosis were similar to ours and again support the concept that this syndrome can be used as an objective measurement of perioperative myocardial injury.
This study identified nine independent preoperative predictors of low cardiac output syndrome after coronary artery bypass grafting (Fig. 1 and Fig. 2). The potential causes for inadequate postoperative cardiac performance are not well established.