During isolated CABG, the use of intraoperative transesophageal echocardiography (TEE) may contribute to a lower operative mortality rate for high-risk patients, according to a study published May 3 in the Journal of the American College of Cardiology, and being presented at ACC.21.

Thomas S. Metkus, MD, FACC, et al., looked at a 1,255,860 planned isolated CABG procedures from Jan. 1, 2011, to June 30, 2018, in the Society of Thoracic Surgeons Adult Cardiac Surgery Database. The overall purpose was to identify the correlation between the operative mortality rate and TEE usage.

Among the patients in the study, 676,803 (53.9%) received intraoperative TEE. The results showed that the proportion of CABG patients utilizing TEE increased noticeably over time, reaching 62.1% by 2019, and these patients maintained lower mortality rates across STS risk groups. Additionally, the data identified a link between intraoperative TEE usage and the likelihood of unplanned valve procedures for CABG patients.

"Intraoperative TEE is associated with increased odds of an unplanned valve procedure at time of CABG, suggesting that TEE can identify patients with occult valvular pathology and impact the operative plan," the authors conclude. "Our results support use of intraoperative TEE to improve outcomes in patients undergoing isolated CABG, particularly among the highest risk patients."

"The increased use is consistent with improving outcomes but moving forward, further data is needed," commented Kim A. Eagle, MD, MACC, editor-in-chief of ACC.org.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Interventions and Imaging, Echocardiography/Ultrasound

Keywords: ACC Annual Scientific Session, ACC21, Echocardiography, Transesophageal, Echocardiography, Cardiac Surgical Procedures, Coronary Artery Bypass, Surgeons

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