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| Title | Intraoperative Assessment of Left Ventricular Diastolic Function using Transesophageal Two-Dimensional Color Doppler Echocardiography during Coronary Artery Bypass Grafting |
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| Subtitle | |
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| Authors | Hiroshi Kitahata*1, Kazumasa Orihashi*2, Yong W.Hong*3, Paul L.Goldiner*4, Yasu Oka*4 |
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| Authors(kana) | |
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| Organization | *1Department of Anesthesiology,Tokushima University School of Medicine, *2The First Department of Surgery,Hiroshima University School of Medicine, *3Department of Anesthesiology,Cardiovascular Center,Yonsei University College of Medicine, *4Department of Anesthesiology,Albert Einstein College of Medicine/Montefiore Medical Center |
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| Journal | Circulation Control |
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| Volume | 15 |
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| Number | 1 |
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| Page | 127-134 |
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| Year/Month | 1994/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | 「Abstract」This study was designed to assess the usefulness of intraoperative measurement of left ventricular (LV) diastolic function by transesophageal Doppler echocardiography (TEE) Forty patients were studied, using a TEE probe (3.75 MHz) and an echocardiographic system (SSH-65A, Toshiba). Measurements were performed at: stage 1-after induction of anesthesia ; stage 2-pre-cardiopulmonary-bypass (CPB) but before cannulation ; stage 3-post-CPB after decannulation ; and stage 4-following closure of the chest wall. Doppler-derived diastolic indices included:1) peak E velocity ; 2) peak A velocity ; 3) peak A/E ratio ; 4) area A/E ratio ; and 5) diastolic filling time (DFT). In spite of our expectation for intraoparative application of Doppler-derived diastolic indices for monitoring LV diastolic function, our results showed the followings. Reliable measurements could no be performed mostly in stages 3 and 4: when temporary cardiac pacing was used or dysrhythmia was present in 13 of 40 patients (32.5 %) following CPB and when heart rate (HR) was higher than 90 beats・min-1 and fusion of E and A waves occurred in 12 of 40 patients (30.0 %) at the end of surgery. In addition, hemodynamics, especially HR, and surgical procedures such as opening of the chest, CPB, and revascularization, etc. each appeared to influence Doppler-derived diastolic indices in the different stages during surgery. The HR influenced Doppler-derived diastolic indices most significantly, particularly DFT (r=-0.861, p<0.001). The correlation between DFT and RR interval in both fused E-A waves group and normal E-A waves group showed that DFT was significantly shorter in the former than the latter with the same RR interval. This indicates the former may have a longer isovolumic relaxation time than the latter and this index seems to be useful for evaluating LV diastolic function during coronary artery bypass grafting. |
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| Practice | Basic medicine |
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| Keywords | Coronary artery bypass grafting, Hemodynamics, Left ventricular diastolic function, Pulsed Doppler echocardiography, Transesophageal echocardiography |
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