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The impact of focused transthoracic echocardiography in the pre-operative clinic
journal contribution
posted on 2023-05-17, 16:59 authored by Canty, DJ, Royse, CF, David KilpatrickDavid Kilpatrick, Bowman, L, Royse, AGPatients with suspected or symptomatic cardiac disease, associated with increased peri-operative risk, are often seen by anaesthetists in the pre-assessment clinic. The use of transthoracic echocardiography in this setting has not been reported. This prospective observational study investigated the effect of echocardiography on the anaesthetic management plan in 100 patients who were older than 65 years or had suspected cardiac disease. Echocardiography was performed by an anaesthetist, and was validated by a cardiologist. Overall, the anaesthetic plan was changed in 54 patients. Haemodynamically significant cardiac disease was revealed in 31 patients, resulting in a step-up of treatment in 20 patients, including: cardiology referral (four patients); altered surgical (two) and anaesthetic (four) technique; use of invasive monitoring (13); planned use of vasopressor infusion (10); and postoperative high dependency care (five). Reassuring negative findings in 69 patients led to a step-down in treatment in 34 patients: altered anaesthetic technique (six); procedure not cancelled (10); cardiology referral not made (10); use of invasive monitoring not required (seven); and high dependency care not booked (11). We conclude that focused transthoracic echocardiography in the pre-operative clinic is feasible and frequently alters management in patients with suspected cardiac disease.
History
Publication title
AnaesthesiaVolume
67Issue
6Pagination
618-625ISSN
0003-2409Department/School
Tasmanian School of MedicinePublisher
Wiley-Blackwell Publishing LtdPlace of publication
The Atrium, Chichester, West Sussex PO19 8SQ, UKRights statement
Copyright 2012 The Association of Anaesthetists of Great Britain and IrelandRepository Status
- Restricted