{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:00:40Z","timestamp":1747184440269,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,10,19]],"date-time":"2019-10-19T00:00:00Z","timestamp":1571443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>No guidelines exist for inpatient postoperative transthoracic echocardiographic (TTE) surveillance in congenital heart disease. We prospectively evaluated indications for postoperative TTEs in patients with congenital heart disease to identify areas to improve upon (Phase 1) and then assessed the impact of a simple pilot intervention (Phase 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included patients with RACHS\u20101 (Risk Adjustment for Congenital Heart Surgery) scores of 2 and 3 to keep the cohort homogenous. During Phase 1, we collected data prospectively to identify postoperative TTEs for which there were no new findings and no associated clinical management decisions (\u201cpotentially redundant\u201d TTEs). During Phase 2, prior to placement of a TTE order, an \u201cEcho Pause\u201d was performed during rounds to prompt review of prior TTE results and indication for the current order. The number of \u201cpotentially redundant\u201d TTEs during Phase 1 vs. Phase 2 was compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During Phase 1, 98 postoperative TTEs were performed on 51 patients. Potentially \u201credundant\u201d TTEs were identified in two main areas: (a) TTEs ordered to evaluate pericardial effusion and (b) TTEs ordered with the indication of \u201cpostoperative,\u201d \u201cfollow\u2010up,\u201d or \u201cdischarge\u201d in the setting of a prior complete postoperative TTE and no apparent change in clinical status. During Phase 2, 101 TTEs were performed on 63 patients. The number of \u201cpotentially redundant\u201d TTEs decreased from 14\/98 (14%) to 5\/101 (5%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that the number of \u201cpotentially redundant\u201d TTEs during inpatient postoperative surveillance of patients with congenital heart disease can be decreased by a simple intervention during rounds such as an \u201cEcho Pause.\u201d<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14505","type":"journal-article","created":{"date-parts":[[2019,10,19]],"date-time":"2019-10-19T10:58:24Z","timestamp":1571482704000},"page":"2078-2085","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cEcho pause\u201d for postoperative transthoracic echocardiographic surveillance"],"prefix":"10.1111","volume":"36","author":[{"given":"Kelly","family":"Cox","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisa","family":"Arunamata","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine D.","family":"Krawczeski","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charitha","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaina K.","family":"Kipps","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Medicine School of Medicine Stanford University Stanford California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J.","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Axelrod","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Hanley","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4654-3794","authenticated-orcid":false,"given":"Elif Seda","family":"Selamet Tierney","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Cardiology School of Medicine Stanford University Palo Alto 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