Article ; Online: Routine preoperative resting echocardiography does not predict adverse cardiopulmonary events after bariatric surgery.
2021 Volume 17, Issue 6, Page(s) 1133–1137
Abstract: Background: A routine resting echocardiography has been suggested as a means to assess cardiac functioning and predict adverse cardiopulmonary events after bariatric surgery.: Objectives: To describe the findings of routine resting echocardiographs ... ...
Abstract | Background: A routine resting echocardiography has been suggested as a means to assess cardiac functioning and predict adverse cardiopulmonary events after bariatric surgery. Objectives: To describe the findings of routine resting echocardiographs in bariatric surgical candidates over a 3-year period and correlate them with observed adverse cardiopulmonary outcomes. Setting: Tertiary-care university-based referral hospital. Methods: We retrospectively reviewed 422 consecutive patients who underwent a laparoscopic sleeve gastrectomy or laparoscopic gastric bypass at our center over 3 years, of whom 321 (76%) received a routine resting preoperative echocardiogram. Abnormal preoperative echocardiogram findings and patient characteristics were recorded. The primary outcome measure was the number of adverse cardiopulmonary events within 30 days of surgery, a composite measure defined as any instance of myocardial infarction, sustained hypotension, stroke, new-onset arrhythmia, heart failure, intensive care admission for cardiopulmonary monitoring, or cardiac arrest. Results: Routine screening preoperative echocardiograms revealed left ventricular (LV) systolic dysfunction in 7 patients (2%), LV diastolic dysfunction in 71 patients (22%), LV hypertrophy in 73 patients (23%), wall motion abnormalities in 4 patients (1%), pulmonary hypertension in 47 patients (15%), left atrial enlargement in 45 patients (14%), and LV enlargement in 6 patients (1%). Adverse cardiopulmonary events occurred in only 4 patients, all of whom had a history of coronary revascularization, and 3 of whom had a prior myocardial infarction. No finding on the routine preoperative echocardiograms was associated with adverse cardiopulmonary events. Conclusion: A routine resting preoperative echocardiography added little to the cardiopulmonary risk stratification of patients who underwent bariatric surgery. High-risk patients were identifiable based on their medical history, particularly those with a known history of coronary artery disease and coronary revascularization. |
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MeSH term(s) | Bariatric Surgery ; Echocardiography ; Heart ; Humans ; Retrospective Studies ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/etiology |
Language | English |
Publishing date | 2021-01-23 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 2274243-8 |
ISSN | 1878-7533 ; 1550-7289 |
ISSN (online) | 1878-7533 |
ISSN | 1550-7289 |
DOI | 10.1016/j.soard.2021.01.021 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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