Diastolic Dysfunction, Morbid Obesity
Conditions
Keywords
Diastolic dysfunction, Morbid Obesity, Bariatric surgery
Brief summary
Morbidly obese patients are at risk for diastolic cardiac dysfunction, which can lead to adverse event, such as, diastolic heart failure postoperatively. Preoperative screening by transthoracic echocardiogram is difficult due to anatomical challenge, therefore the prevalence of this problem may be underestimated. The investigator would like to perform transesophageal echocardiogram in this group of patients after anesthesia induction to demonstrate the true prevalence of this syndrome.
Detailed description
Morbidly obese patients are at risk for both respiratory and cardiovascular abnormalities. Many cardiac problems were previously reported including left ventricular hypertrophy, right and left ventricular systolic dysfunction etc. Diastolic cardiac dysfunction can be found in normal left ventricular systolic function and can lead to diastolic heart failure postoperatively. Preoperative screening by transthoracic echocardiogram is difficult due to anatomical challenge (thick chest wall, narrowing of inter-rib space), therefore the prevalence of this problem may be underestimated. Transesophageal echocardiogram provides better cardiac view, but requires sedation during procedure. So, it is not practical for out-patient setting. The investigator would like to perform transesophageal echocardiogram in this group of patients after anesthesia induction to demonstrate the true prevalence of this syndrome.
Interventions
None listed
Sponsors
Mahidol University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Every patient scheduled for bariatric surgery in Siriraj hospital
Exclusion criteria
* Patient refusal * patient with contraindication for transesophageal echocardiogram such as preexisting esophageal disease, recent upper gastrointestinal bleeding, coagulopathy, etc. (according to American society of Echocardiography guideline)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of diastolic dysfunction | during surgery | Prevalence of diastolic dysfunction according to American society of echocardiography definition |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of other cardiac abnormalities | during surgery | Number of patients with other cardiac abnormalities, both structural and functional abnormalities |
| Incidence of cardiac adverse events | within 24 hours after surgery | Number of patients with cardiac adverse event: myocardial ischemia, pulmonary edema |
| Incidence of pulmonary adverse events | within 24 hours after surgery | Number of patients experienced aspiration, desaturation, re-intubation |
| Incidence of oral and airway trauma | within 24 hours after surgery | Number of patients with new loose teeth, sore throat, difficult to swallow, hoarseness of voice |
| Length of hospital stay | up to 5 days | duration of hospital stay |
Countries
Thailand
Outcome results
None listed