Background: The treatment strategy of early nutritional support after cardiac surgery has gradually been adopted. However, there are no scientific guidelines for the timing and specific programs of early nutritional support. Methods: A retrospective, single-center analysis (2021–2023) was carried out including elderly patients who were admitted for valvular heart disease and received open-heart valve replacement surgery. We designated patients who started the optimized nutritional support after surgery as the optimized enteral nutritional support strategy TN (EN) group and those who received traditional nutritional support as the traditional nutritional support strategy (TN) group. The nutritional and immune indexes, postoperative complications, length of hospital stay, and hospitalization cost of the two groups were compared and analyzed. Results: We identified 378 eligible patients, comprising 193 (51%) patients in the EN group and 185 (49%) patients in the TN group. There was no significant difference in hospital mortality between the two groups, but the proportion of nosocomial pneumonia was significantly lower in the EN group than in the TN group (P < 0.001). In the Poisson regression analysis, EN was not associated with an increase in gastrointestinal complications (P = 0.549). The EN group also seemed to have shorter hospital stays and lower hospitalization expenses (P < 0.001). In the comparison of postoperative gastrointestinal complications, fewer patients experienced diarrhea (P = 0.021) and abdominal distension (P = 0.033) in the EN group compared with the TN group. Conclusion: The optimal nutritional support strategy could effectively improve the clinical outcome of high-risk patients with valvular heart disease.

Background: Defecation delay is a common symptom in patients after tricuspid valve replacement (TVR). Previous studies have demonstrated that defecation delay was associated with worse clinical outcomes of critically ill patients. Our study aimed to investigate the incidence and risk factors of defecation delay in patients after TVR and its adverse clinical outcomes. Methods: A retrospective study was conducted in 206 patients undergoing TVR under cardiopulmonary bypass from May 2005 to July 2021. According to the first postoperative defecation time after surgery, patients were divided into the delayed group (>3 days) and control group (≤3 days). Baseline characteristics and preoperative, intraoperative, and postoperative data were collected to investigate the clinical outcomes of defecation delay. Results: Among the 206 patients, 51.9% (107/206) cases were classified into the defecation delay group. Univariate analysis showed that age (P = 0.043), preoperative platelets (PLT) (P < 0.001), cardiopulmonary bypass (CPB) time (P = 0.013), minimum rectal temperature (P = 0.042), and the use of prokinetic drugs (P = 0.015) were significantly different in the two groups. In addition, the perioperative adverse events in the defecation delay group were significantly higher than that of the control group. Logistic regression analysis indicated that the mortality of patients was associated with postoperative renal dysfunction (P = 0.047) and postoperative respiratory failure (P = 0.004) but was not associated with defecation delay (P > 0.05). Conclusion: Patients with defecation delay after TVR were more likely to appear adverse events, however, defecation delay was not associated with mortality after TVR.