Preoperative Transthoracic Echocardiography Findings in Patients Undergoing Non-Cardiac Surgery in a Tertiary Care Hospital: a Retrospective Study

Abstract

Introduction: Patients with cardiovascular diseases are prone to developing cardiac complications during surgery. The patient’s history and physical examination alone do not provide enough information for an anesthetic plan. Preoperative transthoracic echocardiography (TTE) provides more specific and useful information. The objective of the study is aimed to determine the positive findings of preoperative TEE in patients undergoing non-cardiac surgery. Methods: A retrospective descriptive study was conducted from October 1, 2020 to September 30, 2021 with patients aged 18 years or older who received TTE examination before non- cardiac surgery. Based on the demographic data, major perioperative cardiovascular complications were collected from the preanesthetic evaluation forms, anesthesia consultation forms, as well as anesthesia and medical records. Results: 419 of 17,968 patients (2.3%) undergoing non-cardiac surgery received TTE examinations just before anesthesia, of which 191 (45.6%) were emergency cases. Most indications for TTE, operated by anesthesiologists (63.3%) and cardiologists (36.7%), were cardiac murmur (37.9%), high cardiac risk patients or high-risk surgery (20.0%), and coronary artery disease or suspected (15.8%). Abnormal TTE results, found in 348 patients (83.1%), included abnormal valve (58.3%), low ejection fraction (11.8%), left ventricular hypertrophy (9.2%), pulmonary hypertension (0.6%) and others (20.1%). Further, 12 patients experienced major perioperative cardiac complications. Conclusion: Preoperative TTE can detect abnormal findings up to 83.1%, mostly in cardiac valve lesions. Therefore, prospective randomized control studies should be further studied to evaluate the clinical efficacy of preoperative TTE performed by anesthesiologists.