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Pediatric cardiac surgery after exclusively echocardiography-based diagnostic work-up.

Abstract：

:This study was performed to evaluate the accuracy of exclusively non-invasive preoperative diagnostic work-up based on echocardiography and to assess the safety of cardiac surgery using this diagnostic approach in children with heart disease. During a 3. 5-year period, accuracy of preoperative (invasive and non-invasive) diagnostic work-up was prospectively tested by comparison with the intraoperative findings obtained by surgical inspection and transoesophageal echocardiography. Included were all consecutive 358 children undergoing cardiac surgery (except pulmonary artery bandings and ductus ligations) during the study period at our institution. Of the patients, 44% were operated on in infancy, 84% of procedures were on cardiopulmonary bypass. Echocardiography as the only preoperative imaging modality was used in 231 patients (65%), in the other children, a diagnostic catheter was done. Diagnostic errors occurred in 3.9% (n=5) of patients after diagnostic catheter and in 6.9% (n=16) of patients with echocardiography only. Major diagnostic errors (resulting in prolongation of cardiac bypass time) were observed at equal frequency in both groups (1.7% or four children in the echo-only group and 1.6% or two patients in the catheter group). In no case was the outcome affected by the previously unrecognized findings. It was shown that diagnostic cardiac catheterization could be avoided in a majority of pediatric patients prior to surgical palliation or correction of cardiac defects, without increasing the risk of complications or the overall outcome.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Pfammatter JP,Berdat P,Hämmerli M,Carrel T

doi

10.1016/s0167-5273(00)00278-3

subject

Has Abstract

pub_date

2000-07-31 00:00:00

pages

185-90

issue

2-3

eissn

0167-5273

issn

1874-1754

pii

S0167527300002783

journal_volume

74

pub_type

临床试验,杂志文章

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