INTRODUCTION
Risk scoring systems for cardiac surgery patients first became popular with the Parsonnet score to calculate mortality risk [1]. Though subsequent evolution allows for calculation of postoperative morbidity [2] and reflects advances in our understanding of the patient’s determinants for risk [3], these risk scoring systems remain imperfect [4, 5].
It is now recognized that cardiac performance during diastole influences morbidity [6] [7]. We have previously shown that, in patients undergoing coronary artery bypass (CAB) and/or Aortic Valvular surgery, diastolic function evaluated by preoperative Transthoracic Echocardiography (TTE) predicts hospital stay in patients with varying degrees of systolic function [8]. That study did not address the predictive capacity of transesophageal echocardiography (TEE), in which parameters of LV’s nonsystolic function (e.g. LA max volume) are much less reliably [9-11] or less practically [12, 13] obtained.
This is a prospective cohort study involving subjects with normal systolic function undergoing CAB surgery to evaluate the association between intraoperative TEE metrics of LV performance during diastole and postoperative outcomes. The TEE algorithm depends on a limited number of metrics of performance during diastole and is validated to predict 5 year composite outcomes following CAB [14]. We hypothesized that the algorithm would be associated with duration of hospitalization after CAB.