Is Transesophageal Echocardiography Needed before Hospital Discharge in Patients after Bentall Surgery?

Waldmann, Victor; Iung, Bernard; Messika–Zeitoun, David; Lepage, Laurent; Ghodbane, Walid; Brochet, Éric; Vahanian, Alec; Nataf, Patrick; Jondeau, Guillaume

doi:10.1016/j.echo.2016.10.001

Cited by 1 publication

(1 citation statement)

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“…Echocardiography, which mainly consists of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), has been widely applied in preoperative, intraoperative, and postoperative CS patients and, to some extent, TEE is currently the gold standard for diagnosis after CS [ 8 , 9 , 10 ]. Compared with TEE, TTE is more frequently used by clinicians for hemodynamic management and guides decision-making at the ‘point-of-care’ because it is non-invasive, easy, and quickly feasible [ 11 , 12 , 13 ]. Furthermore, several studies had also demonstrated that some parameters of TTE could serve as an independent predictor for AKI in patients with different types of diseases, as well as CS patients [ 14 , 15 , 16 ].…”

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confidence: 99%

Predictive Value of the Transthoracic Echocardiography Index for Acute Kidney Injury after Cardiac Valve Surgery

Guo

Cao

et al. 2022

JCDD

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Background: We aimed to demonstrate whether the preoperative transthoracic echocardiography index (TTEI) could improve the predictive value of clinical parameters for cardiac valve surgery-associated acute kidney injury (CVS−AKI). Methods: A total of 213 patients who underwent surgical CVS at Renmin Hospital of Wuhan University were consecutively recruited in this retrospective study. TTE assessments were performed within 7 days before surgery and logistic regression was used to determine TTEI. A nomogram was constructed by integrating TTEI and clinical features, and the net reclassification index (NRI) and integrated discrimination improvement (IDI) were applied to evaluate the improvement in TTEI for CVS−AKI. Results: Among them, 66 patients (30.9%) developed CVS−AKI. The TTEI was calculated as follows: −6.579 + 0.068 × pulmonary artery systolic pressure (mmHg) −0.742 × LVEF (>55%, yes or no) + 0.346 × left ventricle posterior wall thickness (mm). The nomogram based on the TEEI and other clinical factors possessed excellent performance (C-index = 0.880), had great calibration and discrimination, and was clinically useful. Furthermore, NRI (0.07, 95% confidence interval, 95%CI, 0.01–0.12, p = 0.02) and IDI (0.08, 95%CI, 0.01–0.20, p = 0.02) indicated that TTEI could significantly improve the predictive value of clinical features for CVS−AKI. Conclusions: As a simple access and cost-effective parameter, the preoperative TTEI may be a reliable and useful factor for CVS−AKI.

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