The Left Ventricular Outflow Tract Changes in Size and Shape From Pre- to Post-Cardiopulmonary Bypass: Three-Dimensional Transesophageal Echocardiography
| Autor: | Caroline Hunter, Andrew Maslow, Tzonghuei Chen, Michelle Gorgone, Feroze Mahmood, Patricia Apruzzese |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
3d analysis Echocardiography Three-Dimensional 030204 cardiovascular system & hematology law.invention 03 medical and health sciences Patient type 0302 clinical medicine 030202 anesthesiology law Internal medicine medicine Cardiopulmonary bypass Ventricular outflow tract Humans Retrospective Studies Retrospective review Cardiopulmonary Bypass business.industry Reproducibility of Results Aortic Valve Stenosis medicine.disease Anesthesiology and Pain Medicine Aortic valve stenosis Cardiology Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 35(3) |
| ISSN: | 1532-8422 |
| Popis: | To compare two-dimensional (2D) and 3D imaging of the left ventricular outflow tract (LVOT) and to evaluate geometric changes pre- to post-cardiopulmonary bypass (CPB).Retrospective review of intraoperative transesophageal echocardiographic examinations.Single academic medical center.The study comprised 69 cardiac surgical patients-27 with aortic valve stenosis (AS) and 42 without AS.Two-dimensional and 3D analysis of the LVOT pre- and post-CPB.Pre- and post-CPB 2D assessment of LVOT diameter (2D LVOTd) was compared with 3D analysis of the minor (3D LVOTd-min) and major diameters. LVOT areas (LVOTa) were calculated using LVOTd to yield 2D LVOTa and 3D LVOTa-min. These were compared with LVOTa measured by planimetry (3D LVOTa-plan). An ellipticity ratio (ER) (ER = 3D minor/major axes) was calculated. The 2D LVOTd was larger than the 3D LVOTd-min before (2.12 v 2.02 cm respectively (resp); p0.001) and after (1.96 v 1.85 cm resp; p = 0.04) CPB. Compared with pre-CPB, there were significant decreases in the 2D LVOTd (p = 0.003) and the 3D LVOTd-min (p0.001) post-CPB. Ellipticity increased after CPB (ER 0.80 v 0.75; p = 0.004), and the 2D LVOTa was larger than the 3D LVOTa-min before CPB (3.60 cmThe LVOT is smaller and more elliptical after CPB. Patients with AS have a smaller LVOT compared with non-AS patients. LVOTa calculated using LVOTd underestimates the 3D LVOTa-plan by as much as 23% depending on patient type and timing of measurement. Accurate assessment of the LVOT requires 3D imaging. |
| Databáze: | OpenAIRE |
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