Unlocking insights: Cardiac ultrasound's impact on non-cardiac surgery

• Published in: Archives of cardiovascular diseases 2025-01, Vol.118 (1), p.S67-S67
• Main Authors: Ben Arbia, H., Chenik, S., Mahfoudhi, H., Ben Ayed, H., Jabloun, T.Y., Haggui, A., Hajlaoui, N., Fehri, W.
• Format: Article
• Language: English
• ISSN: 1875-2136
• DOI: 10.1016/j.acvd.2024.10.124

Cardiac ultrasound is the cornerstone of non-invasive examinations in assessing cardiac function in non-cardiac surgery (NCS). Our study aimed to shed the light on the contribution of cardiac ultrasound in NCS. We conducted a study focusing on 241 cases of cardiac ultrasound requests for preoperative assessments in NCS from 2021 to 2023 in our cardiology department. We compared requested data with expert recommendations and assessed the input of cardiac ultrasounds in these evaluations. The mean age of the study population was 62±17 years and sex ratio was 1,43. 2% of patients were classified as low surgical risk, 32% as intermediate risk, and 5.8% as high risk. Only 6.6% of cardiac ultrasound requests in preoperative evaluations for NCS aligned with the 2014 ESC recommendations, 41.9% with the AHA 2014 guidelines, and 12.4% with the BSE 2013 guidelines. Despite the expanded indications in the 2022 ESC recommendations, only 36.1% of requests were compatible. Newly diagnosed heart failure with reduced left ventricular ejection fraction (LVEF) was found in 6.6% of cases, elevated left ventricular (LV) filling pressures in 1.24%, and significant valvulopathy in 3.31%. Among patients without known coronary disease, 4.2% had newly discovered segmental LV wall motion abnormalities and 7.9% had pulmonary hypertension. Among 41.9% of the patients whose indications for cardiac ultrasound did not align with expert society recommendations, 8% had newly diagnosed reduced LVEF, 11% had segmental LV wall motion abnormalities, 1% had elevated LV filling pressures, 13% had pulmonary hypertension and 2% had significant valvulopathy. Despite evolving recommendations, cardiac ultrasound remains invaluable in preoperative evaluations for NCS, consistently offering valuable insights.