Presentations 2020: OMFS

393 - Does preoperative echocardiography a?ect surgical planning and outcomes of head and neck ?ap reconstructions?

TH Mihailidis M Perenyei M Achanta K Shah
Presented by: Toni Mihailidis
Morriston Hospital

Introduction The British Society of Echocardiography published guidelines outlining indications for preoperative echocardiograms (ECHOs) for cardiac risk strati?cation in non-cardiac surgery. At our MDT, free ?ap reconstructions may not be o?ered with a 'poor' echo result, however evidence supporting this practice is limited. Our audit had two objectives: 1) To identify patients undergoing major head and neck surgery with or without ?ap reconstructions who underwent preoperative ECHO and assess whether the outcome of which changed operative care, 2) to investigate if ECHO results correlate with postoperative complication rates. Methods Retrospective search of our operative database was conducted from 1/1/17 to 31/12/18. All major resections and ?aps conducted under either Maxillofacial Surgery or Otolaryngology were manually identi?ed. Databases were used to identify which patients had undergone ECHOs prior to intervention. Patient records were reviewed to identify changes in perioperative care and postoperative complications. Results 78 patients underwent resection +/- ?ap reconstructions between 1/1/17 to 31/12/18. 18 underwent ECHOs prior to surgery. We present whether ECHOs had an impact on preoperative decision-making. Low ejection fractions resulted in cancellation of free ?ap reconstructions in 2 cases. We also report data on return to theatre, ?ap and other postoperative complication rates and their relationship to ECHO results. Conclusion A minority of patients undergoing head and neck resections undergo preoperative ECHOs. Low ejection fraction may result in not being considered for a free ?ap. In this series, there was no correlation between a poor ECHO result and postoperative complications.
Consent Statement: There are no details on individual patients reported within the abstract.

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