Hemodynamic transesophageal echocardiography after left ventricular assist device implantation

Nicholas A. Haglund, Simon Maltais, Julian S. Bick, William Costello, Mary Keebler, Mary E. Davis, Nicole M. Tricarico, Chad E. Wagner

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objective The authors hypothesized that the clinical profile of patients undergoing hTEE after continuous flow left ventricular assist device (CF-LVAD) implant would be in patients with greater acuity, more blood product utilization, and longer length of ICU stay, and that hTEE would change clinical management.

Design Retrospective review.

Setting University hospital.

Participants One hundred consecutive patients receiving a CF-LVAD.

Interventions Retrospective review using a standardized electronic form of a miniaturized disposable transesophageal echocardiography probe that documented not only physical findings but also changes in hemodynamic management (hTEE) in CF-LVAD patients.

Measurements and Main Results Of the 100 patients, 41 received an hTEE probe. The INTERMACS score, Leitz-Miller Score, and Kormos score indicated the hTEE group had a statistically significant greater risk of morbidity and mortality. Interoperatively, the hTEE group received more blood products and was more likely to have an open chest. Postoperatively, the hTEE group received more blood products, had a longer total length of stay, and had increased mortality. ICU length of stay, days on inotropes and days on mechanical ventilation were not statistically significant between the 2 groups. Information obtained from hTEE changed ICU management in 72% of studies. Conclusion Retrospective review of CF-LVAD patients revealed that postoperative hTEE is used in sicker CF-LVAD patients and frequently leads to changes in ICU clinical management.

Original languageEnglish (US)
Pages (from-to)1184-1190
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume28
Issue number5
DOIs
StatePublished - Oct 1 2014

Keywords

  • cardiac surgery
  • episodic echocardiography
  • hemodynamic echocardiography
  • intensive care management
  • left ventricular assist device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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  • Cite this

    Haglund, N. A., Maltais, S., Bick, J. S., Costello, W., Keebler, M., Davis, M. E., Tricarico, N. M., & Wagner, C. E. (2014). Hemodynamic transesophageal echocardiography after left ventricular assist device implantation. Journal of Cardiothoracic and Vascular Anesthesia, 28(5), 1184-1190. https://doi.org/10.1053/j.jvca.2014.02.012