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Three-Dimensional Transesophageal Echocardiography for Perioperative Right Ventricular Assessment.
MedLine Citation:
PMID:  22633501     Owner:  NLM     Status:  Publisher    
BACKGROUND: In high-risk cardiac procedures, dynamic analysis of right ventricular (RV) performance is desirable, but the geometric complexity of the RV limits the applicability of current two-dimensional echocardiographic imaging techniques. This study aimed to evaluate the utility of three-dimensional transesophageal echocardiography (TEE) for the perioperative assessment of RV function and dimensions. METHODS: Patients undergoing cardiac surgical procedures with complete TEE examinations were identified and reviewed according to current guidelines to exclude patients with significant coexisting valvular regurgitation. Full-volume, three-dimensional datasets were analyzed by two independent investigators using stand-alone software, and left ventricular and RV dimensions were recorded. RESULTS: Datasets from 50 patients undergoing cardiac surgical procedures were evaluated for this study. The mean RV volume was 111.7 mL (range, 37.5 to 349.7 mL) at end diastole and 67.6 mL (range, 25.5 to 274.4 mL) at end systole. Intraobserver reliability was 0.93 and 0.90 for end diastolic and 0.77 and 0.87 for end systolic volumes. The interobserver reliability for RV volumes was 0.83 at end diastole and 0.86 at end systole. The mean stroke volume was 43.6 mL (range, 12 to 111.2 mL) for the RV and 49.1 mL (range, 19.9 to 102.8 mL) for the left ventricle; the correlation coefficient between the two was 0.85. CONCLUSIONS: Three-dimensional TEE volumetric measurements were reproducible across a wide range of RV dimensions. As postulated by the continuity principle, stroke volume measurements between both ventricles correlated well, supporting the validity of this approach. Therefore, our work provides preliminary evidence that three-dimensional TEE offers reproducible information about RV function and size in the dynamic and complex perioperative setting of cardiac surgical procedures.
Jörn Karhausen; Roman Dudaryk; Barbara Phillips-Bute; J Daniel Rivera; Fellery de Lange; Carmelo A Milano; Madhav Swaminathan; G Burkhard Mackensen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-23
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
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