| Can intraoperative TEE correctly measure residual shunt after surgical repair of ventricular septal defects? | |
| | |
MedLine Citation:
|
PMID: 20229003 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: No groups have yet succeeded in identifying the need for re-repair of residual shunt after surgical repair of ventricular septal defect (VSD) based on quantitative evaluation of the ratio of the pulmonary blood flow to the systemic blood flow (Qp/Qs) by transesophageal echocardiography (TEE). Hence, we studied the accuracy of Qp/Qs as estimated by intraoperative TEE. METHODS: Twenty-six patients undergoing VSD closure were studied. After separation from the cardiopulmonary bypass, the presence and severity of residual leakage was evaluated by color Doppler image, and the Qp/Qs (TEE-derived Qp/Qs) was calculated by measuring the vessel diameter and the velocity-time integral of the flow profiles in the main pulmonary artery and left ventricular outflow tract. Transthoracic echocardiography (TTE) was performed at pre-discharge and at 6-12 months after the correction to confirm the presence and severity of residual leakage. RESULTS: TEE detected only minor leakage, with no indication for re-repair, in 8 of the 26 patients. Nevertheless, TEE-derived Qp/Qs varied from 0.57 to 2.07 and were incorrect in 17 patients (65.4%). This meant that when TEE-derived Qp/Qs was outside the acceptable range, the patient was judged not to be in need of re-repair. TTE at pre-discharge confirmed trivial leakage in 3 patients in whom TEE had also identified similar leakages. These leakages were not observed at the follow-up TTE. CONCLUSION: TEE-derived Qp/Qs lacks the accuracy required to play a crucial role in quantitatively measuring the severity of residual shunt, while two-dimensional TEE can reliably detect residual leakage after VSD closure and lead to optimal judgment on the need for re-repair. |
| | |
Authors:
|
Satoshi Kurokawa; Takayuki Honma; Miki Taneoka; Hidekazu Imai; Hiroshi Baba; Minoru Nomura |
Related Documents
:
|
8522693 - A new doppler method for quantification of volumetric flow: in vivo validation using co... 2642343 - Intracerebral arteriovenous malformations: intraoperative color doppler flow imaging. 22046363 - Responses of peripheral blood flow to acute hypoxia and hyperoxia as measured by optica... |
Publication Detail:
|
Type: Journal Article Date: 2010-03-13 |
Journal Detail:
|
Title: Journal of anesthesia Volume: 24 ISSN: 1438-8359 ISO Abbreviation: J Anesth Publication Date: 2010 Jun |
Date Detail:
|
Created Date: 2010-06-14 Completed Date: 2010-09-10 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8905667 Medline TA: J Anesth Country: Japan |
Other Details:
|
Languages: eng Pagination: 343-50 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, Faculty of Medicine, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan. satokuro@sea.plala.or.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Algorithms Arteriovenous Shunt, Surgical* Blood Gas Analysis Child Child, Preschool Echocardiography, Transesophageal* Electrocardiography Female Follow-Up Studies Heart Catheterization Heart Septal Defects, Ventricular / surgery*, ultrasonography* Humans Image Processing, Computer-Assisted Infant Male Pulmonary Circulation / physiology Reoperation Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Remifentanil versus fentanyl compared in a target-controlled infusion of propofol anesthesia: qualit...
Next Document: Review of chemical signature databases.