| Intra-operative myocardial ischaemia cannot be detected by analysis of transmitral inflow patterns in patients undergoing off-pump coronary surgery. | |
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MedLine Citation:
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PMID: 17594738 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: Transmitral inflow patterns have been used for detection of myocardial ischaemia. However, its diagnostic value has not been tested in anaesthetized and mechanically ventilated patients undergoing coronary artery bypass graft surgery. METHODS: Transmitral inflow patterns were studied by transoesophageal Doppler echocardiography in 43 patients undergoing coronary artery bypass graft surgery without cardiopulmonary bypass after opening of the sternum (baseline) and during grafting of the left anterior descending artery. Peak early (E) and peak late (A) transmitral velocities and their ratio (E/A) were recorded. Myocardial ischaemia was defined by standard criteria using two-dimensional echocardiography and seven-lead electrocardiogram. RESULTS: Thirty-one patients (64 +/- 8 yr, 9 women) fulfilled the predefined inclusion criteria for analysis. During distal revascularization, 16 patients showed myocardial ischaemia and 15 did not. The use of vasoactive drugs, haemodynamic findings and transmitral inflow patterns were similar in both groups at baseline and during grafting. In the ischaemic group, E was 67.1 +/- 13.9 cm s-1 at baseline and 69.5 +/- 23.2 cm s-1 during grafting, and the E/A ratios were 1.3 +/- 0.3 and 1.4 +/- 0.9, respectively. In the non-ischaemic group, E was 64.0 +/- 17.1 cm s-1 at baseline and 60.9 +/- 14.8 cm s-1 during grafting, and the E/A ratios were 1.4 +/- 0.7 and 1.2 +/- 0.3, respectively. CONCLUSIONS: Analysis of Doppler findings of transmitral inflow patterns did not allow for detection of myocardial ischaemia during surgical revascularization of the myocardium. |
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Authors:
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J Wang; M D Seeberger; K Skarvan; I Michaux; F Bernet; R Arsenic; P Buser; M Filipovic |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-06-27 |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 25 ISSN: 1365-2346 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-14 Completed Date: 2009-05-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 1-7 Citation Subset: IM |
Affiliation:
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University Hospital Basel, Department of Anaesthesia, Basel, Switzerland. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Flow Velocity Coronary Artery Bypass / adverse effects* Coronary Vessels / physiopathology, surgery*, ultrasonography Female Humans Intraoperative Complications / diagnosis* Male Middle Aged Mitral Valve / physiopathology* Monitoring, Intraoperative / methods Myocardial Ischemia / diagnosis*, ultrasonography Myocardial Revascularization / adverse effects |
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