Aneurysm Aortic, Diastolic Dysfunction, Heart Failure
Conditions
Keywords
Diastolic Dysfunction, Anesthesia, Preoperative assessment, Postoperative care, TEVAR
Brief summary
Patients scheduled for Thoracic Endovascular Aortic Repair (TEVAR) surgery will have transthoracic echocardiography evaluation of left ventricle diastolic function during the perioperative period.
Detailed description
Patients undergoing TEVAR surgery are a high risk group of developing perioperative cardiovascular complications. Left ventricle diastolic dysfunction is common in this group of patients because of the prevalence of risk factors: \> 60 years old, hypertension, smoking history and diabetes. Because of many predisposing factors that occur during the surgery: stress respond, fluid shifts, anaesthesia and mechanical ventilation. Deterioration of the diastolic function is likely to occur in perioperative period In this study, the investigators will evaluate change in left ventricle diastolic function as a marker for early detection of a myocardial failure in patients scheduled for an elective TEVAR surgery. The examination will be performed preoperatively, shortly after the surgery and 24 hours after the surgery. Aim: The aim of the study is to evaluate the diastolic function of left ventricle in perioperative period after high risk surgery. This may provide a valuable information in preoperative risk stratification and postoperative therapy guidance.
Interventions
None listed
Sponsors
Medical University of Warsaw
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* scheduled TEVAR * \>60 years old
Exclusion criteria
* Atrial fibrillation or other non-sinus rhythms * Atrioventricular blocks * Heart rate change more than 25% postoperatively * Not adequate transthoracic view * Postoperative shock * Sepsis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in left ventricle diastolic function in time | Baseline, 2 hours and 24 hours | Echocardiographic assessment of change in left ventricle diastolic function repeated in time intervals: Baseline before the surgery, 2 and 24 hours after the surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in biochemistry markers: troponins | Baseline, 2 hours and 24 hours | Assessment of change in level of troponins. Baseline before the surgery, 2 and 24 hours after the surgery |
| Change in biochemistry markers: brain natriuretic peptide | Baseline, 2 hours and 24 hours | Assessment of change in level of brain natriuretic peptide. Baseline before the surgery, 2 and 24 hours after the surgery |
| Change in left ventricle systolic function | Baseline, 2 hours and 24 hours | Echocardiographic assessment of change in left ventricle systolic function repeated in time intervals: Baseline before the surgery, 2 and 24 hours after the surgery |
| Hemodynamic parameters: Heart rate | Baseline, 2 hours and 24 hours | Heart rate during echocardiography evaluation. |
| Mortality | up to 30 days | Documentation of in-hospital mortality and 30 days mortality |
| Fluid balance | 72 hours | Monitoring of diuresis hourly, fluid losses and fluids intake |
| Kidney function | 72 hours | Monitoring of glomerular filtration rate and requirement for a dialysis daily |
| Length of stay in hospital | up to 14 days | Documentation of length of stay in hospital since the surgery |
| Hemodynamic parameters: Systolic and diastolic pressure | Baseline, 2 hours and 24 hours | Systolic and diastolic pressure measurements during echocardiography evaluation. Record vasopressors requirement. |
Countries
Poland
Outcome results
None listed