2004

A study by researchers at Cincinnati Children's Hospital Medical Center is helping improve outcomes after heart surgery for children and adolescents.

In a collaborative study involving the divisions of Cardiothoracic Surgery and Pediatric Cardiology at Cincinnati Children's, researchers discovered that routine echocardiograms -- ultrasound tests that use sound waves to allow cardiologists to better see the heart and how it works -- performed prior to hospital discharge improve outcomes after surgery for congenital (present at birth) heart defects.

The study was presented March 9 at the American College of Cardiology (ACC) meeting in New Orleans.

Echocardiography is performed routinely in the operating room at the end of surgical procedures so that surgeons can address any unresolved problems. Much can happen, however, during recovery. Although caregivers can detect much of this, they may be unable to detect everything unless they perform additional tests.

"We set out to find out if routine, predischarge echocardiograms would yield significant information that would be different from that obtained during an operation and perhaps change our management of those children," says Pirooz Eghtesady, MD, PhD, a physician / scientist in the division of cardiothoracic surgery who will present the study at the ACC meeting. "Indeed, we found that predischarge echocardiograms identify a significant number of new findings in comparison to those done in the operating room. This influences the medical or surgical management of a substantial number of patients."

The researchers studied children who underwent cardiac surgery at Cincinnati Children's over a nine month period. All those who had an echocardiogram during surgery also had a predischarge echocardiogram. "We discovered new findings that required significant alteration in surgical or medical management -- some lifesaving -- in about 10 percent of the children," says Martha Willis, PNP, who spearheaded data collection for the study.

The researchers believe the findings not only influence the management of a significant number of patients but also lead to improved outcomes. "The results of open heart surgery are great today," says Dr. Eghtesady. "Here at Cincinnati Children's they represent our effort to pursue perfect care."

Also collaborating on the study were Jareen Meinzen-Derr, MPH; Thomas Kimball, MD; Eric Michelfelder Jr., MD; Linda Cripe, MD; Jeffrey Pearl, MD; and Peter Manning, MD.