The Year in Perioperative Echocardiography: Selected Highlights From 2021

Khoche, Swapnil; Choi, Christine; Kothari, Perin; Hamm, Kyle; Poorsattar, Sophia P.; Maus, Timothy M.

doi:10.1053/j.jvca.2022.04.002

Cited by 2 publications

(3 citation statements)

References 54 publications

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“…This is explained primarily by the fact that the routine assessment of RV function is not included in the scope of the preoperative examination. The studies of recent years that we cited above and the reviews [ 23 , 24 ] emphasize the need to assess the RV systolic function before cardiac surgery for a more accurate assessment of the prognosis. The present study emphasizes the need for a more comprehensive assessment of the RV function, with a study of the indicators of RV filling as well.…”

Section: Discussionmentioning

confidence: 99%

The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction?

Sumin

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Корок

et al. 2023

JCDD

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Background. This study aimed to investigate the association of preoperative right heart filling indicators with outcomes after coronary artery bypass grafting (CABG) at an 18 month follow up. Methods. Patients who underwent CABG at a single center were included in this study. In addition to the baseline preoperative indicators and perioperative data, initial parameters of the right ventricle (RV) systolic and diastolic function were assessed. Results. Among the 189 patients, a total of 19 (10.0%) MACE (cardiovascular death, nonfatal myocardial infarction and stroke) were recorded during an 18 month follow up. In patients with the development of MACE during the initial examination, the following changes in RV function were revealed compared with the group without MACE: a decrease in the e’t index (8.2 versus 9.6 cm/s, p = 0.029), an increase in the Et/e’t ratio (5.25 vs. 4.42, p = 0.049) and more frequent presence of RV pseudonormal filling (p = 0.03). In the binary logistic regression analysis, the development of MACE 18 months after CABG was associated with the nonconduction of PCI before surgery, the presence of peripheral atherosclerosis, an increase in IVST and Et/e’t and a decrease in LVEF. Conclusions. RV diastolic dysfunction in the preoperative period was associated with the development of MACE within 18 months after CABG, and the ratio Et/e’t was one of the independent predictors of MACE in a multiple regression analysis. This makes it expedient to include an assessment of not only systolic but also diastolic RV function in the preoperative examination. The inclusion of an assessment of RV diastolic function in the pre-CABG evaluation of patients deserves further study.

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Section: Discussionmentioning

confidence: 99%

The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction?

Sumin

Щеглова

Корок

et al. 2023

JCDD

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“…In addition, a recent nationwide analysis revealed an improved mortality rate among patients who received a PAC for management after ST-elevation myocardial infarction and cardiogenic shock requiring temporary percutaneous LVAD support [14 && ]. Given the immense complexity of the management of end stage heart failure patients, there is greater recognition of the importance of standardization of right heart catheterization to better define the role of advanced hemodynamics in heart failure [15…”

Section: Pulmonary Artery Cathetermentioning

confidence: 99%

“…Finally, there is greater recognition of the potential complications associated with TEE. Recent reviews highlighted the low (typically < 1%), but important risk of gastrointestinal and oropharyngeal injury that can result from placement and manipulation of the TEE probe and providers are encouraged to assess for preexisting oropharyngeal or esophageal abnormalities that can predispose patients to complications [26 ▪▪ ,27 ▪ ]. As a recent multicenter randomized controlled trial showed, video laryngoscope assisted probe insertion can reduce both the number of placement attempts and subsequent likelihood of oropharyngeal injury [28 ▪ ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative hemodynamic monitoring in cardiac surgery

Grant,

Salenger,

Lobdell

2023

Current Opinion in Anaesthesiology

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Purpose of review Cardiac surgery has traditionally relied upon invasive hemodynamic monitoring, including regular use of pulmonary artery catheters. More recently, there has been advancement in our understanding as well as broader adoption of less invasive alternatives. This review serves as an outline of the key perioperative hemodynamic monitoring options for cardiac surgery. Recent findings Recent study has revealed that the use of invasive monitoring such as pulmonary artery catheters or transesophageal echocardiography in low-risk patients undergoing low-risk cardiac surgery is of questionable benefit. Lesser invasive approaches such a pulse contour analysis or ultrasound may provide a useful alternative to assess patient hemodynamics and guide resuscitation therapy. A number of recent studies have been published to support broader indication for these evolving technologies. Summary More selective use of indwelling catheters for cardiac surgery has coincided with greater application of less invasive alternatives. Understanding the advantages and limitations of each tool allows the bedside clinician to identify which hemodynamic monitoring modality is most suitable for which patient.

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The Year in Perioperative Echocardiography: Selected Highlights From 2021

Cited by 2 publications

References 54 publications

The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction?

The Outcomes of Coronary Artery Bypass Surgery after 18 Months—Is There an Influence of the Initial Right Ventricle Diastolic Dysfunction?

Perioperative hemodynamic monitoring in cardiac surgery

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