Evaluating Impact of Surgical Myocardial Revascularization on Global Left Ventricular Systolic Function and Immediate Postoperative Outcome using Transesophageal Echocardiography

• DOI: 10.4103/jss.jss_176_23
• Publication Date: 2024-10-30T15:33:42Z
• Authors: Abhijeet Shitole; Veerappa Kothiwale; Sharanagouda Patil; Preeti Lamba; Anand Vagarali; Jabbar Momin; Sweta Sooragonda; Anushri Patil
• Keywords: Ventricular Function; Myocardial Revascularization

Abstract Background and Aims: Surgical myocardial revascularization is supposed to improve the global left ventricular (LV) function by improving blood supply in significantly occluded coronary arteries. Transesophageal echocardiography (TEE) provides an excellent opportunity evaluate cardiac operating room. Present study was aimed at evaluating impact of surgical on LV systolic function. Comparison fractional shortening (LV-FS), area change (LV-FAC), ejection fraction (LV-EF), indexed volumes (indexed end diastole, systole) “Tei” (Myocardial performance) index obtained prior after done for quantitative analysis. Also, determinants immediate postoperative outcome were evaluated based need pharmacological and/or mechanical cardiovascular support, ventilation, intensive care unit (ICU) stay, morbidity mortality period. These measures correlated with baseline values TEE derived echo indices. Methods: One hundred ten subjects significant artery disease scheduled elective surgery. Fourteen excluded due presence either hemodynamic instability requiring or before ( n = 6), Grade III mitral regurgitation (MR) 2) arrythmias 6). Ninety six using revascularization. Subjects followed ICU outcome. Immediate measured as “good” “poor” vasoactive inotropic score, requirement Intra-aortic balloon counter pulsation (IABP) support (VA-ECMO) maintain output, duration mortality. Results: In 96 analyzed, there a improvement LV-FS (38.60 ± 16.38 vs. 31.31 13.14) P 0.002), FAC (51.94 16.06 43.99 16.02) ≤ 0.001), EF (53.08 9.97 46.71 7.53) < 0.00001), diastolic volume (34.84 13.43 40.08 17.22) 0.0188) (0.47 0.13 0.53 0.13) 0.0007). Thirty three required prolonged stay (>7 days), 20) ventilatory (>24 h), 10) (IABP/VA ECMO placement), 7) suffered period categorized Presence type II diabetes mellitus, Chronic obstructive pulmonary (COPD), higher grade ischemic MR, larger volume, use cardiopulmonary bypass allogenic transfusion during surgery Conclusion: improved irrespective EF. strongly determined diabetes, COPD, MR volumes. Preoperative (Baseline) performance did not determine following LVEF >35%.