Dataset Information

Pulmonary valve reconstruction during conduit revision: Technique and transesophageal echocardiography imaging.

ABSTRACT: Transesophageal echocardiography can be a useful adjunct in assessing the quality of repair in patients undergoing novel methods of reconstruction of the right ventricular outflow. We present one such patient here.

SUBMITTER: Talwar S

PROVIDER: S-EPMC5661315 | biostudies-literature | 2017 Oct-Dec

REPOSITORIES: biostudies-literature

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Pulmonary valve reconstruction during conduit revision: Technique and transesophageal echocardiography imaging.

Talwar Sachin S Kapoor Poonam Malhotra PM Singh Sukhjeet S Das Deepanwita D Sharma Kamal Prakash KP Airam Balram B

Annals of cardiac anaesthesia 20171001 4

Transesophageal echocardiography can be a useful adjunct in assessing the quality of repair in patients undergoing novel methods of reconstruction of the right ventricular outflow. We present one such patient here. ...[more]

PMID: 28994681

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Project description:BackgroundDespite recommendations regarding the use of intraoperative transesophageal echocardiography (TEE), there is no randomized evidence to support its use in cardiac valve surgery. The purpose of this study was to compare the clinical outcomes of patients undergoing open cardiac valve repair or replacement surgery with and without transesophageal echocardiographic monitoring. The hypothesis was that transesophageal echocardiographic monitoring would be associated with lower 30-day mortality and shorter length of hospitalization.MethodsIn this observational retrospective cohort study, Medicare claims were used to test the association between perioperative TEE and 30-day all-cause mortality and length of hospitalization among patients undergoing open cardiac valve repair or replacement surgery between January 1, 2010, and October 1, 2015. Baseline characteristics were defined by inpatient and outpatient claims. Medicare death records were used to ascertain 30-day mortality. Statistical analyses included regression models and propensity score matching.ResultsA total of 219,238 patients underwent open cardiac valve surgery, of whom 85% underwent TEE. Patients who underwent TEE were significantly older and had greater comorbidities. After adjusting for patient demographics, clinical comorbidities, surgical characteristics, and hospital factors, including annual surgical volume, the TEE group had a lower adjusted odds of 30-day mortality (odds ratio, 0.77; 95% CI, 0.73 to 0.82; P < .001), with no difference in length of hospitalization (<0.01%; 95% CI, -0.61% to 0.62%; P = .99). Results were similar across all analyses, including a propensity score-matched cohort.ConclusionsTransesophageal echocardiographic monitoring in cardiac valve repair or replacement surgery was associated with lower 30-day risk-adjusted mortality, without a significant increase in length of hospitalization. These findings support the use of TEE as routine practice in open cardiac valve repair or replacement surgery.

Dataset Information

Pulmonary valve reconstruction during conduit revision: Technique and transesophageal echocardiography imaging.

Publications

Pulmonary valve reconstruction during conduit revision: Technique and transesophageal echocardiography imaging.

Similar Datasets

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