Perioperative Evaluation of Regional Wall Motion by Transesophageal Two-Dimensional Echocardiography

Clements, Fiona M.; Bruijn, Norbert P. de

doi:10.1213/00000539-198703000-00009

Cited by 96 publications

(13 citation statements)

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“…Transoesophageal echocardiography (TEE) represents a major advance in the monitoring of cardiac function and can provide information on both L V volumes and myocardial ischaemia (Van Daele et al, 1990). Regional wall motion abnor-malities (RWMA) of the LV demonstrated by TEE are accepted as the earliest and most sensitive indicators of intra-operative myocardial ischaemia, preceding both electrocardiographic and haemodynamic changes (Smith et al, 1985;Clements and De Bruyn, 1986;Van Daele et al, 1990).…”

mentioning

confidence: 99%

Intra‐operative Myocardial Ischaemia detected by Biplane Transoesophageal Echocardiography during Transurethral Prostatectomy

Heyns¹,

Rittoo²,

Sutherland³

et al. 1993

British Journal of Urology

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Recent studies have shown an increased late mortality rate due to cardiovascular causes after transurethral compared with open prostatectomy. This has been linked to the demonstration of haemodynamic changes during transurethral prostatectomy, which may cause ischaemic myocardial injury. We used transoesophageal echocardiography (currently the most sensitive modality for detecting myocardial ischaemia) to study 26 patients during prostatectomy under general anaesthesia. Evidence of myocardial ischaemia (as shown by the development of new regional wall motion abnormalities of the left ventricle) occurred in 4 of 22 patients during transurethral and in 3 of 4 patients during retropubic prostatectomy. An intra-operative fall in systolic as well as diastolic blood pressure occurred in 21 of 22 patients during the transurethral procedure and in all 4 patients during retropubic prostatectomy. The duration of anaesthesia and the operation, and the intra-operative blood loss did not differ significantly between patients with and without evidence of intra-operative myocardial ischaemia. However, the maximum intra-operative fall in systolic and diastolic blood pressure, as well as the mass of the prostatic tissue removed, were significantly greater in patients with than in those without evidence of intra-operative myocardial ischaemia, suggesting that the latter may be related to the extent of surgery and the degree of intraoperative hypotension. In this study, 7 of 26 patients (27%) showed evidence of myocardial ischaemia during prostatectomy. However, it remains difficult to explain why intra-operative myocardial ischaemia should result in an increased cardiovascular mortality rate several years after the operation.

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confidence: 99%

Intra‐operative Myocardial Ischaemia detected by Biplane Transoesophageal Echocardiography during Transurethral Prostatectomy

Heyns¹,

Rittoo²,

Sutherland³

et al. 1993

British Journal of Urology

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“…The de velopment of new regional ventricular wall motion abnor malities is a sensitive indicator of myocardial ischemia and may precede electrocardiographic evidence of isch emia [14,15].…”

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confidence: 99%

Use of Dynamic Two-Dimensional Transesophageal Echocardiography for Renal Cell Carcinoma with Cavoatrial Tumor Thrombus

Eyre

Hurley²,

Burger³

et al. 1995

Urol Int

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Renal cell carcinoma with inferior vena caval tumor thrombus extending to the level of the right atrium occurs in about 1 % of all cases. Dynamic two-dimensional transesophageal echocardiography is a minimally invasive safe technique that can demonstrate preoperatively the cephalad extent of the cavoatrial tumor thrombus with an accuracy that appears equal to or better than that of any other method currently available. When used intraoperatively, it provides invaluable data to aid in the anesthetic and surgical management of the patient, obviating the need for and potential risk of placing a Swan-Ganz pulmonary artery catheter before complete removal of the tumor thrombus.

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“…TEE ( Hewlett Packard ,Sonos 1500@, equipped with a 5-MHz biplane probe ) was used for LVWM assessment at the transgastric short-axis view (mid-P level) dividing the ventricle into anterior, septal, inferior and lateral segments. It has previously been shown that this view depicts myocardial muscle supplied from all three major coronary vessels (8), and that the mid-P level segments usually are involved in myocardial ischaemia (10). It is also known that the contraction of these segments is concentric in the normal state and therefore more easily assessed.…”

Section: Methodsmentioning

confidence: 98%

Perioperative transoesophageal echocardiography with low‐dose dobutamine stress for evaluation of myocardial viability: a feasible approach?

Palmgren

Houltz

1998

Acta Anaesthesiol Scand

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Since we regard the visual assessment of LVWM as being more applicable for this protocol than the semiautomatic analysis, we conclude that low-dose dobutamine stress echocardiography seems to be a feasible method for detecting viable myocardium in the anaesthetised patient scheduled for elective CABG surgery. However, the semiautomatic analysis complemented our findings, since the variations in pre- and afterload did not significantly change the size of the left ventricle, which hereby would imply LVWM changes.

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Perioperative Evaluation of Regional Wall Motion by Transesophageal Two-Dimensional Echocardiography

Cited by 96 publications

References 0 publications

Intra‐operative Myocardial Ischaemia detected by Biplane Transoesophageal Echocardiography during Transurethral Prostatectomy

Intra‐operative Myocardial Ischaemia detected by Biplane Transoesophageal Echocardiography during Transurethral Prostatectomy

Use of Dynamic Two-Dimensional Transesophageal Echocardiography for Renal Cell Carcinoma with Cavoatrial Tumor Thrombus

Perioperative transoesophageal echocardiography with low‐dose dobutamine stress for evaluation of myocardial viability: a feasible approach?

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