Echocardiography as Risk-Assessment for Major Adverse Cardiac Events in Major Vascular Surgery Patients

University of Virginia

Status: Completed

Conditions: Heart Valve Diseases; Right-Sided Heart Failure; Left-Sided Heart Failure

Study type: Observational

Funder types: Other

Identifiers

NCT04836702

20906

Details and patient eligibility

About

Patient with coronary artery disease (CAD), heart failure and abnormal heart function undergoing major vascular surgery have a high associated high morbidity and mortality with myocardial infarction accounting for 33-50% of perioperative deaths. The prevalence of CAD in vascular surgery patients approaches 50%. Proper pre-procedure protocols to accurately assess patients and determine who may require further medical optimization prior to undergoing surgery help mitigate risk and improve outcomes. The investigators designed this study as a single center, retrospective cohort analysis to explore the association between ventricular (LV and RV function) and valvular (Aortic / Mitral / Tricuspid) function and expanded major adverse cardiac events (X-MACE).

Enrollment: 813 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Major vascular surgery operation (e.g. CEA, open aortic repair, suprainguinal and infrainguinal bypasses, EVAR, TEVAR) captured in the UVA Vascular Quality Initiative database
• Echocardiography within two years of index operation

Exclusion criteria

• If patient had additional qualifying vascular procedure within 30 days of the index operation, this procedure was excluded

Trial design

813 participants in 3 patient groups

Left ventricular function

Description:

* Depressed LV function 1. LV ejection fraction \< 50% 2. LV systolic function; defined as mild / mod / sev decreased 3. LV diastolic function; defined as mild (g1 ) / mod (g2) / sev ( g3) decreased * Normal LV function

Right ventricular function

Description:

* Depressed RV function a. RV systolic function defined as mild / mod / sev decreased * Normal RV function

Valvular lesions

Description:

* Moderate or severe valvular lesions 1. Aortic stenosis 2. Aortic regurgitation 3. Mitral stenosis 4. Mitral regurgitation 5. Tricuspid regurgitation * Clinically normal valvular lesions 1. No valvular lesion 2. Mild stenosis / regurgitation of above mentioned lesions