Clinical InvestigationThree-Dimensional EchocardiographyFeasibility of Intraoperative Three-Dimensional Transesophageal Echocardiography in the Evaluation of Right Ventricular Volumes and Function in Patients Undergoing Cardiac Surgery
Section snippets
Methods
The study population consisted of 150 nonconsecutive patients who underwent 2D TEE monitoring during cardiac surgery between June 2009 and January 2011: 65 undergoing mitral valve (MV) repair for prolapse, 10 undergoing MV and tricuspid valve (TV) repair, four with congenital heart diseases, two undergoing Jarvik implantation, 13 undergoing aortic valve surgical replacement (six with aortic regurgitation and seven with aortic valve stenosis), and 56 undergoing transcatheter aortic valve
Results
Clinical characteristics of the study population and the feasibility of 3D TEE RV volume assessment are shown in Table 1, separately for preoperative and postoperative TEE data. The reconstruction of the RV preoperative and postoperative TEE volumes was feasible in 98.7% (n = 148) and 92.7% (n = 139) of patients, respectively. The time required for each real-time 3D acquisition was about 38 ± 20 sec, whereas for each analysis, the time required was up to 5 min. The mean quality scores of
Discussion
The importance of RV function in cardiac surgery outcomes has been largely proven.1, 2, 3, 4 An accurate estimation of RV function may improve risk stratification in patients undergoing surgery and in those with postoperative hemodynamic instability, in whom acute RV failure is known to be a significant cause of morbidity and mortality in the perioperative period after valvular and congenital surgery, coronary artery bypass, or heart transplantation.5, 23
Over the past decades, 2D
Conclusions
Intraoperative TEE assessment of RV volumes and function is feasible and reproducible both in patients with normal RV function and in those with dilated right ventricles, without being excessively time consuming. The good correlations found between 3D TEE and TTE data, as well as between preoperative and postoperative TEE differences in EDV and EDA, demonstrate the reliability of this procedure for 3D RV quantification, which could improve the intraoperative evaluation of RV function.
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