Health Condition 1: I259- Chronic ischemic heart disease, unspecified
Conditions
Interventions
Intervention1: Nil: Nil
Sponsors
Postgraduate Institute of Medical Education and Research
Eligibility
Inclusion criteria
Inclusion criteria: 1.Adult patients above 18 years scheduled for elective, isolated CABG and AVR for aortic stenosis. 2.Ability to provide informed consent. 3.Feasibility of obtaining technically adequate Transthoracic Echocardiography (TTE) windows at both T1 and T2 time points.
Exclusion criteria
Exclusion criteria: 1.Emergency/Salvage cardiac surgery. 2.Prior history of cardiac surgery (to avoid complex confounding of ventricular geometry). 3.Pre-existing severe primary valvular heart disease (other than the indication for AVR). 4.Technical inability to perform adequate TTE at either T1 or T2. Need for immediate post-intubation hemodynamic support that prevents the 15-minute T2 assessment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To find the agreement of peak early diastolic mitral annular velocity (lateral e ) and. (Medial e ) measured by TTE Awake and TTE Mechanically ventilatedTimepoint: T1 (Baseline): Before induction of anaesthesia while the patient is breathing spontaneously T2: Fifteen minutes after intubation and initiation of mechanical ventilation, after hemodynamic stabilization | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in TR velocity & estimated PASP between T1 & T2Timepoint: Baseline / T1: Pre-induction, while the patient is awake & breathing spontaneously T2: Fifteen minutes after endotracheal intubation & initiation of mechanical ventilation, after hemodynamic stabilization & before surgical incision;Change in pulmonary venous S, D, & S/D ratio between T1 & T2Timepoint: Baseline / T1: Pre-induction, while the patient is awake & breathing spontaneously T2: Fifteen minutes after endotracheal intubation & initiation of mechanical ventilation, after hemodynamic stabilization & before surgical incision;Identification of diastolic parameters most & least affected by positive pressure ventilationTimepoint: Baseline / T1: Pre-induction, while the patient is awake & breathing spontaneously T2: Fifteen minutes after endotracheal intubation & initiation of mechanical ventilation, after hemodynamic stabilization & before surgical incision;Proportion of patients with reclassification of LV diastolic dysfunction grade between T1 & T2Timepoint: Baseline / T1: Pre-induction, while the patient is awake & breathing spontaneously T2: Fifteen minutes after endotracheal intubation & initiation of mechanical ventilation, after hemodynamic stabilization & before surgical incision;Predictors of LVDD grade discordance between T1 & T2Timepoint: Baseline / T1: Pre-induction, while the patient is awake & breathing spontaneously T2: Fifteen minutes after endotracheal intubation & initiation of mechanical ventilation, after hemodynamic stabilization & before surgical incision;Association of LVDD grades with duration of mechanical ventilationTimepoint: From postoperative ICU admission until successful extubation / discontinuation of mechanical ventilation.;Association of LVDD grades with ICU length of stayTimepoint: From postoperative ICU admission until ICU discharge.;Association of LVDD grades with need for inotropic or vasopressor supportTimepoint: From postoperative ICU admission until discon | — |
Countries
India
Contacts
Public ContactDr Sunder Lal Negi
Postgraduate Institute of Medical Education and Research
Outcome results
None listed