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.
KEY WORDS
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Article info
Publication history
Published online: August 04, 2014
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
