Heart valve disease, heart failure, pericardial effusion
Conditions
Interventions
Group 1: Inclusion criteria
• Patients = 18 years
• Patients who are regularly informed about anesthesia preoperatively
• Non-cardiac surgery patients for elective surgery or
Intervention with ane
Sponsors
Klinik für Anästehsiologie, Universitätsmedizin Göttingen
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: • Patients who are regularly informed about anesthesia preoperatively • Non-cardiac surgery patients for elective surgery or Intervention with anesthesia • Consent to participate in this study after providing detailed information by an investigator • At least one of the following criteria/symptoms is present: – Newly occurring dyspnea of ??unclear origin with reduced exercise capacity (< 4 metabolic equivalents or < 100 W) before planned surgery with medium or high risk of cardiovascular complications – As yet unexplained worsening of symptoms of known heart failure in the last 12 months – Previously unexplained or unknown heart murmurs before planned surgery with a medium or high risk of cardiovascular complications (even with normal exercise capacity) – Patients with the above-mentioned symptoms/criteria without deterioration in the last 12 months but present TTE (maximum 12 months old)
Exclusion criteria
Exclusion criteria: • Lack of consent to participate in the study • Pregnancy • Cardiac surgery • GUCH patients • Urgent or emergency surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Difference of the preoperatively determined procedure based on the findings of the anesthesia TTE versus cardiology TTE | — |
Secondary
| Measure | Time frame |
|---|---|
| A) Agreement of the following TTE measurements: 1.) Visual left ventricular function (LV function: normal, moderately impaired, severely impaired) 2.) Visual right ventricular function (RV function: normal, moderately impaired, highly impaired) 3.) Right heart strain (yes/no) 4.) TAPSE, tricuspid annular plane systolic excursion (difference > 3 mm if RV function is restricted) 5.) Wall motion disorders (yes/no; region: 17-zone diagram) 6.) Assessment of the heart valve disease (stenosis or insufficiency: normal, moderate, severe) a.) Aortic valve b.) Tricuspid valve c.) Mitral valve 7.) Pericardial effusion 8.) Volume status: a.) VCI diameter ( 50%) c.) CVP estimate: VCI 50% = 5 mmHg VCI 2cm - Collapse >50%= 15 mmHg VCI > 2cm - Collapse <50%= 20 mmHg B) Perioperative consequences as a result of TTE: • Necessary preoperative diagnostics (e.g. cardiological or internal medicine consultation) and, if necessary, therapeutic optimization of the cardiac disease (e.g. heart failure, aortic valve stenosis) • Postponement of the operation date (e.g. to optimize heart failure) • Change in anesthesia procedure: general anesthesia versus regional anesthesia versus analgesic sedation • Change in perioperative monitoring (e.g. arterial versus non-invasive Blood pressure measurement, placement of central venous catheter) • Planning of postoperative monitoring (outpatient procedure versus normal ward versus intermediate care ward versus intensive care unit) | — |
Countries
Germany
Contacts
Public ContactBenedikt Büttner
Klinik für Anästhesiologie, Universitätsmedizin Göttingen
Outcome results
None listed