Transesophageal echocardiography for monitoring segmental wall motion during off-pump coronary artery bypass surgery.
Anesth Analg
; 99(4): 965-973, 2004 Oct.
Article
in En
| MEDLINE
| ID: mdl-15385335
ABSTRACT
In this prospective, observational study, we evaluated whether transesophageal echocardiography allows for monitoring left ventricular segmental wall motion during cardiac displacement for off-pump coronary artery bypass (OPCAB) surgery. On the basis of a pilot study that showed frequent loss of transgastric views during OPCAB surgery, we analyzed only midesophageal views. The midesophageal 4-chamber view, 2-chamber view, and long-axis view were recorded in 60 patients after opening the chest and placing an epicardial stabilizer on the displaced heart. Using the 16-segment model, 2 echocardiographers independently performed offline analysis of segmental wall motion. The percentage of patients in whom >or=14 left ventricular segments were readable was calculated at baseline and after cardiac displacement and placement of an epicardial stabilizer. At baseline, >or=14 segments were readable in 59 (98%) of 60 patients. After cardiac displacement, >or=14 segments were readable during 58 (76%) of 76 revascularizations of the left anterior descending coronary artery (P < 0.01 versus baseline), during 33 (83%) of 40 revascularizations of the left circumflex coronary artery (P < 0.01 versus baseline), and during 29 (94%) of 31 revascularizations of the right coronary artery (not significant). We conclude that the number of readable segments decreased after cardiac displacement but that availability of >or=14 readable segments allowed for reliable monitoring of segmental wall motion in 4 of 5 patients during OPCAB surgery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Bypass
/
Echocardiography, Transesophageal
/
Heart
Type of study:
Observational_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Anesth Analg
Year:
2004
Document type:
Article
Affiliation country: