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

Authors: Klein, A. A.¹; Snell, A.¹; Nashef, S. A. M.²; Hall, R. M. O.¹; Kneeshaw, J. D.¹; Arrowsmith, J. E.¹

Source: Anaesthesia, Volume 64, Number 9, September 2009 , pp. 947-952(6)

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Abstract:

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.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2044.2009.05991.x

Affiliations: 1: Department of Anaesthesia and Critical Care 2: Department of Surgery, Papworth Hospital, Cambridge, UK

Publication date: 2009-09-01