Additional Cross-sectional Transesophageal Echocardiography Views Improve Perioperative Right Heart Assessment
Additional Cross-sectional Transesophageal Echocardiography Views Improve Perioperative Right Heart Assessment
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额外的横断面经食管超声心动图视图可改善围手术期右心评估
DOI：
10.1097/aln.0b013e318269054b
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发表时间：
2012
期刊：
影响因子：
8.8
通讯作者：
M. Seeberger
中科院分区：
文献类型：
--
作者：
J. Kasper;D. Bolliger;K. Skarvan;P. Buser;M. Filipovic;M. Seeberger
背景：右心衰是围手术期发病率和死亡率的重要原因，经食管超声心动图（TEE）对其诊断至关重要。然而，在目前的术中TEE指南中推荐的20个横断面视图中，只有4个聚焦于右心脏。本研究分析了在标准TEE检查中加入额外的观点是否能改善对右心的评估。方法：60例患者在麻醉诱导后进行标准TEE检查。此外，还获得了以右心为中心的5个视图。离线分析测试：(1)是否可以像标准视图一样可靠地获取额外的TEE视图，包括右心的部分；在预先设定的9节段模型基础上，合并额外的视图是否能改善对8个或更多右心室壁节段的评估；(3)三尖瓣或肺动脉瓣在两个或两个以上平面上；(4)经瓣三尖瓣和肺动脉正位血流。结果：附加视图的成像可靠性（88%）与标准视图（90%）相当。合并一些额外的视图可以评估8个或更多的右心室段，59例（98%），而18例（30%）仅通过标准视图，60例（100%）和15例（25%）在两个或两个以上平面的肺动脉瓣。另外几个视图改善了经瓣肺动脉流量的正位评估，但没有改善三尖瓣血流。结论：以右心为中心的额外TEE视图与标准视图一样可靠。将其中三项纳入标准TEE检查可以提高对右心的综合评估。
Background:Right heart failure is an important cause of perioperative morbidity and mortality, and transesophageal echocardiography (TEE) is crucial for its diagnosis. However, only four of the 20 cross-sectional views recommended in current guidelines for intraoperative TEE focus on the right heart. This study analyzed whether incorporating additional views into the standard TEE examination improves assessment of the right heart. Methods:Sixty patients underwent standard TEE examination after induction of anesthesia. In addition, five views focusing on the right heart were acquired. Offline analysis tested: (1) whether the additional TEE views can be acquired as reliably as standard views including parts of the right heart; whether incorporating additional views improves the assessment of (2) eight or more right ventricular wall segments based on a predefined nine-segment model; (3) the tricuspid or pulmonary valve in two or more planes; and (4) transvalvular tricuspid and pulmonary flow in orthograde fashion. Results:Additional views could be imaged as reliably (88%) as standard views (90%). Incorporating some of the additional views allowed the assessment of eight or more right ventricular segments in 59 (98%) versus 18 patients (30%) by the standard views alone, and of the pulmonary valve in two or more planes in 60 (100%) versus 15 patients (25%). Several additional views improved orthograde assessment of transvalvular pulmonary flow, but not of tricuspid flow. Conclusions:The additional TEE views focusing on the right heart can be acquired as reliably as standard views. Incorporating three of them into the standard TEE examination improves comprehensive assessment of the right heart.
影响因子：
2.8
作者：
McConnell, MV;Solomon, SD;Lee, RT
通讯作者：
Lee, RT