ArticleCongenital heart disease2017
Utility of a standardized postcardiopulmonary bypass epicardial echocardiography protocol for stage I Norwood palliation.
Article in Congenital heart disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 7 citations in OpenAlex.
- Noninvasive Imaging in Interventional Cardiology: Hypoplastic Left Heart Syndrome.Frontiers in cardiovascular medicine · 2021Review
- Application of the Boston Technical Performance Score to intraoperative echocardiography.Echo research and practice · 2019Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectiveStage 1 Norwood palliation is one of the highest risk procedures in congenital cardiac surgery. Patients with superior technical performance scores have more favorable outcomes. Intraoperative epicardial echocardiography may allow the surgeon to address residual lesions prior to leaving the operating room, resulting in improved technical performance. The ability of intraoperative epicardial echocardiography to visualize the relevant anatomy and its association with outcomes is not known.
designA standardized intraoperative epicardial echocardiography protocol was developed and performed at the conclusion of Stage 1 Norwood palliation. Data pertaining to visualization of relevant anatomy, and comparison of intraoperative echocardiogram findings with other postoperative investigations was performed. Clinical outcomes, including technical performance, were collected. A historical cohort who received either no echocardiogram or a nonstandardized examination was used as a comparison group.
resultsThirty on-protocol and 30 preprotocol patients, 22 of whom had a nonstandardized intraoperative epicardial echocardiogram, were studied. Compared with preprotocol, visualization of the relevant anatomy was significantly increased for the Damus-Kaye-Stansel anastomosis (93% vs. 68% P = .03) and branch pulmonary arteries (70% vs. 36%, P = .02). One residual lesion requiring immediate operative reintervention was diagnosed in the preprotocol group. There were 5 patients in each cohort with residual lesions during the postoperative hospitalization that were not appreciated on the intraoperative echocardiogram. Technical performance, rates of reintervention and clinical outcomes were not significantly different between the two groups.
conclusionsIntraoperative epicardial echocardiography is technically feasible and increases visualization of the relevant anatomy. Larger investigations may be warranted to determine if there is clinical benefit to such an approach.
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