Application of transesophageal echocardiography to continuous intraoperative monitoring of left ventricular performance.
Application of transesophageal echocardiography to continuous intraoperative monitoring of left ventricular performance.
复制标题
经食管超声心动图在术中连续监测左心室性能中的应用。
DOI：
10.1016/0002-9149(80)90611-6
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发表时间：
1980
期刊：
影响因子：
--
通讯作者：
E. Sonnenblick
中科院分区：
文献类型：
--
作者：
M. Matsumoto;Y. Oka;J. Strom;W. Frishman;A. Kadish;R. Becker;R. Frater;E. Sonnenblick
应用经食管M型超声心动图对21例心脏直视手术患者（瓣膜病11例，冠心病10例）的左室内径进行了连续监测。超声心动图记录在六个阶段的程序，并同时测量心输出量（染料稀释）和心房压力。经食管技术测量的左心室直径与标准胸骨旁方法获得的相应测量值相关性良好。在容量超负荷的患者中，手术矫正伴随着舒张期尺寸、环周纤维缩短速度、中壁应力和舒张末期刚度的降低以及心输出量的增加。心包和胸壁闭合通常导致心输出量显著减少，并与舒张期内径减小和左心室刚度常数增加相关。因此，心输出量的减少可能是由于心包和胸壁的机械限制导致的心室腔扩张性降低。心包打开导致间隔运动显著延迟，通过关闭心包逆转。本研究证实了经食管超声心动图的有效性及其在心脏手术中监测心室功能变化的有用性。
Transesophageal M mode echocardiography was used for continuous monitoring of left ventricular dimensions in 21 patients (11 with valvular and 10 with coronary heart disease) undergoing open heart surgery. Echocardiograms were recorded in six stages of the procedure and simultaneous measurements of cardiac output (with dye dilution) and atrial pressures were made. Measurements of left ventricular diameters with the transesophageal technique correlated excellently with the corresponding measurements obtained with the standard parasternal method. In patients with volume overload, surgical correction was accompanied by a decrease In diastolic dimension, velocity of circumferential fiber shortening, mid wall stress and end-diastolic stiffness, and an increase in cardiac output. Pericardial and chest wall closures generally caused a significant decrease in cardiac output, and correlated with a decrease In diastolic diameter and an increase in the stiffness constant of the left ventricle. Thus, the decrease in cardiac output may have been due to decreased distensibility of the ventricular cavity secondary to mechanical restriction by the pericardium and chest wall. Pericardial opening caused a significant delay in septal motion that was reversed by closing the pericardium. This study confirms the validity of transesophageal echocardiography and its usefulness in monitoring changes in ventricular function during cardiac surgery.