Transesophageal echocardiographic evaluation of native aortic valve area: Utility of the double-envelope technique
| Autor: | Andrew Maslow, J.Michael Haering, John S. Mashikian, Robert A. Levine, Stephanie Heindel, Pamela S. Douglas |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Aortic valve medicine.medical_specialty Ventricular Function Left Coronary Circulation Internal medicine Humans Medicine Ventricular outflow tract Prospective Studies Aged Observer Variation Ventricular function business.industry University hospital medicine.disease Stenosis Anesthesiology and Pain Medicine Aortic valve area medicine.anatomical_structure Aortic Valve cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal Envelope (motion) Surgical patients |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 15:293-299 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/jcan.2001.23272 |
| Popis: | To assess the accuracy of aortic valve area (AVA) calculations using the continuity equation with data obtained from the double envelope (DE) (simultaneously obtained left ventricular outflow tract [V1]) and aortic valve [V2] velocities) during intraoperative transesophageal echocardiography (TEE).Prospective study; measurements were performed on-line.University hospital.Cardiac and noncardiac surgical patients (n = 75) with recent aortic valve assessment (3 months) undergoing general anesthesia or endotracheal intubation.Intraoperative AVA was measured by the continuity equation using the DE technique (DE/TEE) and by planimetry (PL/TEE). Left ventricular outflow tract diameter was obtained from midesophageal views, whereas subvalvular (V1) and valvular (V2) velocities were obtained simultaneously using continuous-wave Doppler from transgastric views. V1 was also obtained using pulsed-wave Doppler. Measurements were compared with AVA obtained preoperatively by the Gorlin equation during cardiac catheterization (G/CATH) or by transthoracic echocardiography using the traditional continuity equation (C/TTE) (nonsimultaneously obtained V1 and V2).A DE was obtained in 73 of 75 patients (97%). Four patients had atrial fibrillation at the time of the examination, whereas the rest were in sinus rhythm. PL/TEE was performed in 54 of 71 patients with sinus rhythm (76%). Agreement was good between DE/TEE and G/CATH (mean bias, 0.02 cm(2) [SD, 0.24 cm(2)]), and C/TTE (mean bias, -0.05 cm(2) [SD, 0.16 cm(2)]). Agreement was not as good between PL/TEE and G/CATH (mean bias, -0.07 cm(2) [SD, 0.28 cm(2)]) and C/TTE (mean bias, -0.13 cm(2) [SD, 0.30 cm(2)]). V1 obtained by pulsed-wave Doppler and with DE closely agreed (mean bias, 0.01 m/sec [SD, 0.05 m/sec]).TEE evaluation of native AVA using the DE technique is feasible and in good agreement with that obtained by C/TTE and G/CATH. Compared with DE/TEE, PL/TEE did not agree as well. Use of DE/TEE should simplify the continuity equation and may minimize errors resulting from beat-to-beat variability in stroke volume. |
| Databáze: | OpenAIRE |
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