Clinical Implications of Preoperative Echocardiographic Findings on Cardiovascular Outcomes Following Vascular Surgery: An Observational Trial

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Jan 19

PMID 36656845

Authors

Matthew J Meyer

Slater A Jameson

Edward J Gillig

Ankur Aggarwal

Sarah J Ratcliffe

Mary Baldwin

Karen E Singh

W Darrin Clouse

Randal S Blank

Affiliations

Soon will be listed here.

Abstract

Introduction: Peripheral artery disease and cardiac disease are often comorbid conditions. Echocardiography is a diagnostic tool that can be performed preoperatively to risk stratify patients by a functional cardiac test. We hypothesized that ventricular dysfunction and valvular lesions were associated with an increased incidence of expanded major adverse cardiac events (Expanded MACE).

Methods And Materials: Retrospective cohort study from 2011 to 2020 including all patients from a major academic center who had vascular surgery and an echocardiographic study within two years of the index procedure.

Results: 813 patients were included in the study; a majority had a history of smoking (86%), an ASA score of 3 (65%), and were male (68%). Carotid endarterectomy was the most common surgery (24%) and the least common surgery was open abdominal aortic aneurysm repair (5%). We found no significant association between the echocardiographic findings of left ventricular dysfunction, right ventricular dysfunction, or valvular lesions and the postoperative development of Expanded MACE.

Conclusions: The preoperative echocardiographic findings of left ventricular dysfunction, right ventricular dysfunction and moderate to severe valvular lesions were not predictive of an increased incidence of postoperative Expanded MACE. We identified a significant association between RV dysfunction and post-operative dialysis that should be interpreted carefully due to the small number of outcomes. The transition from open to endovascular surgery and advances in perioperative management may have led to improved cardiovascular outcomes.

Trial Registration: Trial Registration: NCT04836702 (clinicaltrials.gov). https://www.google.com/search?client=firefox-b-d&q=NCT04836702.

Citing Articles

Epidemiology of perioperative RV dysfunction: risk factors, incidence, and clinical implications.

Shelley B, McAreavey R, McCall P Perioper Med (Lond). 2024; 13(1):31.

PMID: 38664769 PMC: 11046908. DOI: 10.1186/s13741-024-00388-6.

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