Assessment of left ventricular size and function during cardiac surgery

• Verfasst von: Großgasteiger, Manuel [VerfasserIn]
• Verfasst von: Hien, Maximilian [VerfasserIn]
• Verfasst von: Graser, Bastian [VerfasserIn]
• Verfasst von: Rauch, Helmut [VerfasserIn]
• Verfasst von: Gondan, Matthias [VerfasserIn]
• Verfasst von: Motsch, Johann [VerfasserIn]
• Verfasst von: Rosendal, Christian [VerfasserIn]
• Titel: Assessment of left ventricular size and function during cardiac surgery
• Titelzusatz: an intraoperative evaluation of six two-dimensional echocardiographic methods with real time three-dimensional echocardiography as a reference
• Verf.angabe: Manuel Grossgasteiger, Cand. Med., Maximilian D. Hien, M.D., Bastian Graser, M.Sc., Helmut Rauch, M.D., Matthias Gondan, Ph.D., Johann Motsch, M.D. and Christian Rosendal, M.D
• E-Jahr: 2013
• Jahr: 14 February 2013
• Umfang: 10 S.
• Fussnoten: Gesehen am 28.01.2021
• Titel Quelle: Enthalten in: Echocardiography
• Ort Quelle: Armonk, NY : Futura, 1984
• Jahr Quelle: 2013
• Band/Heft Quelle: 30(2013), 6, Seite 672-681
• ISSN Quelle: 1540-8175
• DOI: doi:10.1111/echo.12116
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: intraoperative three-dimensional transesophageal echocardiography
• Sach-SW: peak systolic pressure rise
• Sach-SW: prospective observational study
• Sach-SW: Simpson's method of discs
• Sach-SW: speckle tracking
• Sach-SW: Teichholz' method
• K10plus-PPN: 1745920676

Abstract

Transesophageal echocardiography is recommended to monitor left ventricular (LV) size and function in various operations. Generally, two-dimensional (2D) methods are applied intraoperatively. The aim of this study was to compare the accuracy and feasibility of 6 commonly used 2D methods to assess LV function during surgery. LV function in 120 consecutive patients was evaluated. Real time three-dimensional transesophageal echocardiograpy (3DTEE) served as reference. End-diastolic and end-systolic volumes and ejection fraction (EF) were analyzed with Simpson's method of discs (monoplane [MP] and biplane [BP]), eyeball method, Teichholz' method, and speckle tracking (ST) methods. Furthermore, fractional area change (FAC) and peak systolic pressure rise (dP/dt) were determined. Each 2D method was evaluated regarding correlation and agreement with 3DE, intra- and interobserver variability and the time required for evaluation. Simpson BP showed the strongest correlation and best agreement with 3DE for EF (limits of agreement 3.7 ± 11.6%) and volumes. Simpson MP showed similar agreement with 3DE compared to ST (2.8 ± 14.5% vs. 2.0 ± 15.3% and 3.8 ± 14.4% vs. 1.9 ± 15.6%, respectively). Both the eyeball method and Teichholz' method showed wide limits of agreement (−1.5 ± 18.2% and 5.2 ± 22.1%, respectively). DP/dt did not correlate with 3DE. FAC and ST FAC showed similar agreement. Application of 3DE (429 ± 108 seconds) took the longest time, and the eyeball method took the shortest time (8 ± 5 seconds) for analysis. Simpson BP is the most accurate intraoperative 2D method to evaluate LV function, followed by long-axis MP evaluations. Short-axis views were less accurate but may be suited for monitoring. We do not recommend using dP/dt.