0327: Echocardiography improves the risk prediction of peri-operative outcomes in patients undergoing coronary bypass surgery? A prospective study

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• 作者：Claire Serena ; Baptiste Salerno ; Julien Magne ; ^{jul.magne@yahoo.fr" class="auth_mail" title="E-mail the corresponding author} ; Florence Rolle ; Dania Mohty ; Marc Laskar ; Victor Aboyans
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：42
• 全文大小：488 K

文摘

To assess the performance of transthoracic echocardiographic (TTE) parameters to predict operative mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) and to compare their pronostic value to that obtained by the Society of Thoracic Surgeon (STS) score.

Materiels and Methods

We prospectively collected the clinical and biological data required to calculate the STS score in patients hospitalized for CABG. A preoperative TTE was performed for each patient. Primary endpoint was 30-days mortality or major morbity (i.e. stroke, renal failure, prolonged ventilation, deep sternal wound infection, reoperation) as defined by the STS. Secondary end-point was prolonged hospitalization >14 days.

Results

172 patients were included (mean age 66.1±10.2 years, 12.2% were women). The primary end-point occurred in 33 patients (19.2%) and 28 patients (16.3%) had a prolonged hospital stay. Independent predictive factors for the primary end-point were an increased left atrial volume (>31mL/m²) (OR=3.186, IC 95%=1.266; 8.015, p=0.014) and a decreased tricuspid annular plane systolic excursion (TAPSE <20mm) (OR=2.709, IC 95% 1.144; 6.410, p=0.023). The addition of these two parameters to the STS score improved significantly the model performance (figure) with a better risk prediction (Integrated Discrimination Improvement=7.44).

Conclusion

In patients undergoing CABG, preoperative TTE is mandatory as it provides an additional prognostic value to the STS score.