Intraoperative echocardiography is indicated in high-risk coronary artery bypass grafting.

Journal Article (Journal Article)

BACKGROUND: Intraoperative echocardiography is a valuable monitoring and diagnostic technology used in cardiac surgery. This reports our clinical study of the usefulness of intraoperative echocardiography to both surgeons and anesthesiologists for high-risk coronary artery bypass grafting. METHODS: From March to November 1995, 82 consecutive high-risk patients undergoing coronary artery bypass grafting were studied in a four-stage protocol to determine the efficacy of intraoperative echocardiography in management planning. Alterations in surgical and anesthetic/hemodynamic management initiated by intraoperative echocardiography findings were documented in addition to perioperative morbidity and mortality. RESULTS: Intraoperative echocardiography initiated at least one major surgical management alteration in 27 patients (33%) and at least one major anesthetic/hemodynamic change in 42 (51%). Mortality and the rate of myocardial infarction in this consecutive high-risk study population using intraoperative echocardiography and in a similar group of patients without the use of intraoperative echocardiography was 1.2% versus 3.8% (not significant) and 1.2% versus 3.5% (not significant), respectively. CONCLUSIONS: We conclude that when all of the isolated diagnostic and monitoring applications of perioperative echocardiography are routinely and systematically performed together, it is a safe and viable tool that significantly affects the decision-making process in the intraoperative care of high-risk patients undergoing primary isolated coronary artery bypass grafting and may contribute to the optimal care of these patients.

Full Text

Duke Authors

Cited Authors

  • Savage, RM; Lytle, BW; Aronson, S; Navia, JL; Licina, M; Stewart, WJ; Starr, NJ; Loop, FD

Published Date

  • August 1997

Published In

Volume / Issue

  • 64 / 2

Start / End Page

  • 368 - 373

PubMed ID

  • 9262577

International Standard Serial Number (ISSN)

  • 0003-4975

Digital Object Identifier (DOI)

  • 10.1016/S0003-4975(97)00612-7


  • eng

Conference Location

  • Netherlands