Impact of Modified Transesophageal Echocardiography on Mortality and Stroke after Cardiac Surgery : A Large Cohort Study
| Autor: | Arno P. Nierich, Linda M. Peelen, Arnoud W J van 't Hof, Carl Moons, Wouter W. Jansen Klomp, Jan G. Grandjean, George J. Brandon Bravo Bruinsma |
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| Přispěvatelé: | Cardiologie, RS: CARIM - R2.01 - Clinical atrial fibrillation, MUMC+: MA Med Staf Spec Cardiologie (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
PREDICTOR Article Subject 030204 cardiovascular system & hematology DISEASE law.invention 03 medical and health sciences ARTERY-BYPASS SURGERY 0302 clinical medicine THORACIC AORTA law Internal medicine medicine.artery Cardiopulmonary bypass medicine Thoracic aorta Diseases of the circulatory (Cardiovascular) system DIAGNOSTIC-ACCURACY 030212 general & internal medicine Stroke METAANALYSIS CARDIOPULMONARY BYPASS business.industry EuroSCORE Perioperative medicine.disease Large cohort Surgery Cardiac surgery ATHEROSCLEROSIS DISTAL ASCENDING AORTA Relative risk RC666-701 Cardiology UPDATE business Cardiology and Cardiovascular Medicine Research Article |
| Zdroj: | International Journal of Vascular Medicine, Vol 2017 (2017) International Journal of Vascular Medicine. Hindawi Publishing Corporation International journal of vascular medicine, 2017:1857069. Hindawi Publishing Corporation International Journal of Vascular Medicine, 2017. Hindawi Limited International Journal of Vascular Medicine |
| ISSN: | 2090-2824 |
| Popis: | The aim of this study was to investigate the impact of perioperative screening with modified transesophageal echocardiography (A-View method). We compared, in consecutive patients who underwent cardiac surgery between 2006 and 2014, 30-day mortality and in-hospital stroke incidence, operated either with perioperative modified TEE screening (intervention group) or only with conventional TEE screening (control group). Of the 8,605 study patients, modified TEE was applied in 1,391 patients (16.2%). Patients in the intervention group were on average older (71 versus 68 years, p<0.001) and more often females (31.0% versus 28.0%, p<0.001) and had a higher predicted mortality (EuroSCORE I: 5.9% versus 4.0%, p<0.001). The observed 30-day mortality was 2.2% and 2.5% in both groups, respectively, with multivariable and propensity-score adjusted relative risks (RRs) of 0.70 (95% CI: 0.50–1.00, p=0.05) and 0.67 (95% CI: 0.45–0.98, p=0.04). In-hospital stroke was 2.9% and 2.1% in both groups, respectively, with adjusted RRs of 1.03 (95% CI: 0.73–1.45) and 1.01 (95% CI: 0.71–1.43). In patients undergoing cardiac surgery, use of perioperative screening for aortic atherosclerosis with modified TEE was associated with lower postoperative mortality, but not stroke, as compared to patients operated on without such screening. |
| Databáze: | OpenAIRE |
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