From the Guidelines
It is not typical for a cardiac surgeon to order an inpatient echo 1 week post-op for a patient who underwent non-invasive mitral valve repair and is ready for discharge with minimal complications. The standard practice, as recommended by the American College of Cardiology/American Heart Association task force on practice guidelines 1, is to perform an echocardiogram before discharge to confirm successful repair and establish a baseline for future comparison. Some key points to consider in the management of patients after mitral valve repair include:
- Patients who have undergone successful MV repair should undergo 2D and Doppler echocardiography before discharge or at the first postoperative outpatient visit 1.
- The frequency of future follow-up should be determined by the patient’s progress and by local facilities, but ideally all patients who have undergone valve surgery should continue to be followed-up at a cardiac centre 1.
- The frequency of echocardiography during follow-up should be determined by the results of previous echocardiography, symptomatic status, the type of surgery and the existence of other pathology 1. For patients who are clinically stable with minimal complications, scheduling a follow-up outpatient echocardiogram at 1-3 months post-discharge is more common. This approach allows sufficient time for initial healing while still providing timely assessment of valve function. Keeping the patient hospitalized an additional week solely for an echo would increase healthcare costs and exposure to hospital-acquired conditions without clear clinical benefit. If there are specific concerns about the repair or patient-specific risk factors, the surgeon might consider an earlier follow-up echo, but this would typically be done on an outpatient basis rather than extending the inpatient stay.
From the Research
Ordering an Inpatient Echo Post-Op for Non-Invasive Mitral Valve Repair
- There is no direct evidence from the provided studies to suggest that ordering an inpatient echo 1 week post-op for a patient who underwent non-invasive mitral valve repair is typical or necessary 2, 3, 4, 5, 6.
- The studies primarily focus on the treatment and outcomes of patients with mitral regurgitation, rather than the specific post-operative care for non-invasive mitral valve repair patients 2, 4, 5, 6.
- One study discusses the importance of intraoperative transesophageal echocardiography in mitral valve repair, but does not address post-operative echo orders 3.
- Another study mentions the use of echocardiography to assess the improvement of functional mitral regurgitation after surgical aortic valve replacement, but does not provide guidance on post-operative echo orders for non-invasive mitral valve repair patients 4.
- The remaining studies discuss the treatment and outcomes of patients with secondary mitral regurgitation, but do not address the specific question of ordering an inpatient echo post-op for non-invasive mitral valve repair patients 2, 5, 6.