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Titolo:
Prospective study of routine perioperative transesophageal echocardiography for elective valve replacement: Clinical impact and cost-saving implications
Autore:
Ionescu, AA; West, RR; Proudman, C; Butchart, EG; Fraser, AG;
Indirizzi:
Univ Wales Coll Med, Welsh Heart Res Inst, Dept Cardiol, Cardiff CF14 4XN,S Glam, Wales Univ Wales Coll Med Cardiff S Glam Wales CF14 4XN CF14 4XN,S Glam, Wales Univ Wales Coll Med, Dept Epidemiol, Cardiff CF14 4XN, S Glam, Wales Univ Wales Coll Med Cardiff S Glam Wales CF14 4XN CF14 4XN, S Glam, Wales Univ Wales Coll Med, Dept Cardiac Surg, Cardiff CF14 4XN, S Glam, Wales Univ Wales Coll Med Cardiff S Glam Wales CF14 4XN CF14 4XN, S Glam, Wales
Titolo Testata:
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
fascicolo: 7, volume: 14, anno: 2001,
pagine: 659 - 667
SICI:
0894-7317(200107)14:7<659:PSORPT>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC SURGICAL-PROCEDURES; MYOCARDIAL REVASCULARIZATION; ASCENDING AORTA; SURGERY; DEFECTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Ionescu, AA Univ Wales Coll Med, Welsh Heart Res Inst, Dept Cardiol, HeathPk, CardiffCF14 4XN, S Glam, Wales Univ Wales Coll Med Heath Pk Cardiff S Glam Wales CF14 4XN les
Citazione:
A.A. Ionescu et al., "Prospective study of routine perioperative transesophageal echocardiography for elective valve replacement: Clinical impact and cost-saving implications", J AM S ECHO, 14(7), 2001, pp. 659-667

Abstract

Transesophageal echocardiography (TEE) is widely used during heart valve replacement operations, but its clinical impact and cost-saving profile havenot been studied prospectively for this indication. We investigated the clinical benefits and cost-savings of routine TEE for elective valve replacement at a regional tertiary center. We prospectively studied 300 patients (140 men; mean age [+/- SD], 66 +/- 9 years) undergoing aortic valve, mitral valve, or double-valve replacements. Transesophageal echocardiography with a biplane (in 161 patients) or a multiplane probe was performed before and after surgery. We assessed whether the TEE findings changed die operation or the postoperative treatment and the cost of TEE either as an extension ofa preexisting service or as a new-development. In 2 patients undergoing aortic valve replacement, significant mitral regurgitation on TEE led to additional mitral valve replacement, and in 1 patient undergoing mitral valve replacement, aortic regurgitation also required aortic valve replacement. Immediate reoperation (dehisced mitral valve prosthesis) and delayed extubation (suspected obstruction of an aortic valve prosthesis) were prompted by postoperative TEE. Extending an existing TEE service to routine intraoperative use saved up to $109 (US) per patient per year. Routine intraoperative TEE can provide major clinical benefit to a small proportion of patients undergoing elective valve replacement, and this can lead to cost savings, but only if the service can be provided without major capital investment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 00:32:31