Journal article
Can Intraoperative Transesophageal Echocardiography Predict Postoperative Aortic Insufficiency in Patients Receiving Implantable Left Ventricular Assist Devices?
Journal of cardiothoracic and vascular anesthesia, Vol.29(4), pp.901-905
08/2015
DOI: 10.1053/j.jvca.2015.01.004
PMID: 25939966
Abstract
Aortic insufficiency (AI) develops in 25% of patients after left ventricular assist device (LVAD) insertion. The objective of this study was to evaluate the occurrence of new-onset AI upon initiation of cardiopulmonary bypass (CPB) required for LVAD insertion and the potential ability of this new-onset AI to predict development of post-LVAD insertion AI.
Forty-one patients undergoing LVAD insertion were studied. Intraoperative transesophageal echocardiography (TEE) evaluation was performed at baseline (post-induction, pre-sternotomy), 5 minutes after CPB initiation, and post-chest closure. Patients were followed up postoperatively for development of AI.
Single university hospital.
Patients undergoing elective LVAD insertion.
None.
At baseline, 35 patients exhibited none—trace AI, 4 exhibited mild AI, 2 exhibited moderate AI, and none exhibited severe AI. After initiation of CPB, 34 patients exhibited no change in degree of AI yet 7 exhibited an increase in AI severity. However, all 7 patients exhibited no change in degree of AI at chest closure and one exhibited a decrease in AI severity. Four patients developed at least moderate AI during the postoperative period (range 3-8 months). However, only one of these patients exhibited an increase in AI severity after initiation of CPB for LVAD insertion. No significant changes in aortic root measurements were observed during the entire intraoperative period (within patients nor between patients with/without development of at least moderate postoperative AI).
One in 5 patients undergoing LVAD insertion will demonstrate an increase in AI severity at CPB initiation without changes in aortic root measurements. None of the information obtained from intraoperative TEE seemed to predict development of at least moderate postoperative AI.
Details
- Title: Subtitle
- Can Intraoperative Transesophageal Echocardiography Predict Postoperative Aortic Insufficiency in Patients Receiving Implantable Left Ventricular Assist Devices?
- Creators
- Suzanne E Kellman - Department of Anesthesia and Critical Care, The University of Chicago, Chicago, ILAndrew J Feider - Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, ILValluvan Jeevanandam - Department of Cardiac and Thoracic Surgery, The University of Chicago, Chicago, ILMark A Chaney - Department of Anesthesia and Critical Care, The University of Chicago, Chicago, IL
- Resource Type
- Journal article
- Publication Details
- Journal of cardiothoracic and vascular anesthesia, Vol.29(4), pp.901-905
- Publisher
- Elsevier Inc
- DOI
- 10.1053/j.jvca.2015.01.004
- PMID
- 25939966
- ISSN
- 1053-0770
- eISSN
- 1532-8422
- Language
- English
- Date published
- 08/2015
- Academic Unit
- Anesthesia
- Record Identifier
- 9984006463902771
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