Document Detail


The impact of intraoperative transoesophageal echocardiography on an unselected cardiac surgical population: a review of 2343 cases.
MedLine Citation:
PMID:  12500510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although intraoperative transoesophageal echocardiography (TOE) has an established role in the management of some cardiac surgical procedures, there is little data on its impact on coronary artery bypass graft (CABG) cases that are stratified for clinical risk. This is a retrospective review of the surgical impact of intraoperative TOE on 2,343 unselected cardiac cases. The surgical impact of TOE findings were rated E (essential)--resulted in changes to the proposed surgical procedure or V (valuable)--the surgical technique for the planned surgery was altered. The surgical impact that routine TOE had on low-, medium- and high-risk CABG cases was also examined. The surgical impact of TOE for the total study population (E + V) was 4.5%. The impact was greatest in combined CABG + mitral valve procedures (18%). The impact in CABG cases was 3.5% overall, with an estimated impact in low-risk patients of 2.8% (95% CI. 2.7-3.0%) versus 6.7% (95% CI. 5.9-7.7%) in high-risk cases. The commonest E-impact in CABG patients was unscheduled valve surgery (2.6% of high-risk patients). The complication rate attributable to TOE was 0.09%. These findings provide indirect evidence for a potential patient benefit from the routine use of TOE in cardiac surgery.
Authors:
A P Forrest; N D Lovelock; J M Hu; S N Fletcher
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  30     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-25     Completed Date:  2003-04-03     Revised Date:  2006-08-28    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  734-41     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Royal Prince Alfred Hospital, Camperdown, N.S.W. 2050.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiac Surgical Procedures*
Coronary Artery Bypass
Echocardiography, Transesophageal* / adverse effects
Female
Humans
Intraoperative Complications / ultrasonography
Intraoperative Period
Male
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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