Lizette Benavides-Villamizar, Facultad de Medicina, Universidad CES; Servicio de Cirugía, Clínica Medellín Sede Occidente. Medellín, Colombia
Hernán D. Castro-Arias, Facultad de Medicina, Universidad CES; Servicio de Cirugía, Clínica Medellín Sede Occidente. Medellín, Colombia
José H. Arias-Botero, Facultad de Medicina, Universidad CES; Medellín, Colombia
Introduction: Myocardial revascularization surgery is one of the cornerstones in the management of patients with ischemic heart disease. Intraoperative echocardiographic evaluation plays a crucial role in the management of these patients. However, the utility of Global Longitudinal Strain (GLS) has not been fully defined in revascularization surgery. Objective: to explore the value of global longitudinal strain and myocardial work efficiency in predicting major cardiovascular complications in patients undergoing myocardial revascularization. Materials and method: this was a retrospective cohort study. Patients with coronary artery disease and an ejection fraction greater than 30% who underwent myocardial revascularization surgery and intraoperative echocardiography from September 2023 to April 2024 were included. They were followed from the time of surgery until 7 days postoperatively or discharge to detect cardiovascular complications. Results: a total of 35 patients were included, with a median age of 68 years. Thirty-four patients underwent elective surgery. Twenty-nine patients experienced easy weaning off the pump, with a median cardiopulmonary bypass time of 67 minutes. The median ICU stay was 3 days. No events of death or extubation failure were reported. The median left ventricular GLS was –12.5% and the median MW was 75%. It was observed that patients with lower strain had a higher likelihood of developing low cardiac output or shock, cardiogenic edema, and/or difficult weaning off the pump. Regarding the MW, no significant correlation or difference was found at the statistical level in the bivariate analysis with the complications. Conclusion: GLS may help predict cardiovascular complications in coronary patients undergoing myocardial revascularization surgery.
Keywords: Strain. Echocardiography. Cardiovascular complications. Coronary disease.
