Related Experiment Video
Updated: Aug 13, 2025
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Clinical implications of preoperative echocardiographic findings on cardiovascular outcomes following vascular
Matthew J Meyer1, Slater A Jameson1, Edward J Gillig2
1Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, United States of America.
Insights
Preoperative echocardiography did not predict major adverse cardiac events (Expanded MACE) in vascular surgery patients. Right ventricular dysfunction showed a possible link to post-operative dialysis, warranting further investigation.
Area of Science:
- Cardiology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Peripheral artery disease and cardiac disease frequently coexist.
- Echocardiography is a key preoperative tool for cardiac risk stratification.
- Major adverse cardiac events (Expanded MACE) are a concern in patients undergoing vascular surgery.
Purpose of the Study:
- To investigate the association between preoperative echocardiographic findings and postoperative Expanded MACE.
- To determine if ventricular dysfunction or valvular lesions predict adverse cardiac outcomes after vascular surgery.
Main Methods:
- Retrospective cohort study (2011-2020) at a major academic center.
- Included patients undergoing vascular surgery with an echocardiogram within two years of the procedure.
- Analyzed 813 patients, assessing left/right ventricular dysfunction and valvular lesions.
Main Results:
- No significant association found between echocardiographic findings (ventricular dysfunction, valvular lesions) and Expanded MACE.
- A potential association between right ventricular dysfunction and post-operative dialysis was noted, requiring cautious interpretation due to small sample size.
Conclusions:
- Preoperative echocardiographic findings of ventricular dysfunction and moderate-to-severe valvular lesions are not predictive of postoperative Expanded MACE.
- Improved perioperative management and surgical techniques may contribute to better cardiovascular outcomes.
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.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:22Aneurysm IV: Nursing Management
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...