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European Journal of Cardio-Thoracic Surgery, Vol 7, 371-375, Copyright © 1993 by European Association for Cardio-thoracic Surgery

ARTICLES

Evaluation of left ventricular function utilizing transesophageal echocardiography during and after thoracic aortic aneurysm repair

H Imagawa, H Takano, M Kato, Y Yoshioka and K Ohnishi
Division of Cardiovascular Surgery, Osaka Prefectural Hospital, Japan.

This study was designed to evaluate left ventricular (LV) function during aortic cross-clamping (ACC) by comparing left heart bypass (LHB) with a centrifugal pump and simple aortic cross-clamping (SC). The end- diastolic volume index (EDVI), ejection fraction (EF), fractional shortening (FS) and end-systolic meridional stress (ESS) were measured by transesophageal echocardiography. The measurements were performed 1) before ACC, 2) 2 min after ACC, 3) 20 min after ACC, 4) 2 min after unclamping and 5) 1 h after unclamping. With cross-clamping, a significant decrease was observed in both EDVI (108 vs 83 ml/m2) and EF (73 vs 67%) in patients with LHB. Patients utilizing SC showed a sustained increase in ESS (43 vs 64 10(3) dyne/cm2). The systolic blood pressure did not vary during LHB, but a transient increase occurred in patients with SC. With release of the cross-clamping, EDV and EF returned to the baseline values in patients with LHB. A significant decrease occurred in EDVI (101 vs 71 ml/m2) and ESS (61 vs 36 10(3) dyne/cm2) in the SC group. We conclude that circulatory support with LHB may offer greater stability of the LV function during thoracic aortic cross-clamping than SC because of the lower preload and afterload.

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				A. J. Bryan, B. Barzilai, and N. T. Kouchoukos Transesophageal Echocardiography and Adult Cardiac Operations Ann. Thorac. Surg., March 1, 1995; 59(3): 773 - 779. [Abstract] [Full Text]