The impact of intra‐operative transoesophageal echocardiography on cardiac surgical practice

Summary The use of transoesophageal echocardiography during cardiac surgery has increased dramatically and it is now widely accepted as a routine monitoring and diagnostic tool. A prospective study was carried out between September 2004 and September 2007, and included all patients in whom intra‐ope...

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Bibliographic Details
Published in:Anaesthesia 2009-09, Vol.64 (9), p.947-952
Main Authors: Klein, A. A., Snell, A., Nashef, S. A. M., Hall, R. M. O., Kneeshaw, J. D., Arrowsmith, J. E.
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiac Surgical Procedures - methods
Decision Making
Echocardiography, Transesophageal - utilization
Heart Diseases - diagnostic imaging
Heart Diseases - surgery
Heart surgery
Humans
Impact analysis
Medical sciences
Monitoring, Intraoperative - methods
Prospective Studies
Ultrasonic imaging
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Summary:Summary The use of transoesophageal echocardiography during cardiac surgery has increased dramatically and it is now widely accepted as a routine monitoring and diagnostic tool. A prospective study was carried out between September 2004 and September 2007, and included all patients in whom intra‐operative echocardiography was performed, 2 473 (44%) out of a total of 5 591 cases. Changes to surgery were subdivided into predictable (where echocardiographic examination was planned specifically to guide surgery) and unpredictable (new pathology not diagnosed pre‐operatively). A change in the planned surgical procedure was documented in 312 (15%) cases. In 216 (69%) patients the changes were predictable and in 96 (31%) they were unpredictable. The number of predictable changes increased between 2004–5 and 2006–7 (8% vs 13%, p = 0.025). In these cases, intra‐operative echocardiography was specifically requested by the surgeon to help determine the operative intervention. This has implications for consent and operative risk, which have yet to be fully determined.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2009.05991.x