Transesophageal echocardiographic findings of intracardiac events during cardiac assist
| Autor: | Hiroshi Fujiwara, Michihiro Nasu, Yukikatsu Okada, Kiyoshi Tatemichi, Sunao Nishiuchi, Toyo Shomura, Jun Sono |
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| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output medicine.medical_treatment Biomedical Engineering Cardiac Output Low Medicine (miscellaneous) Bioengineering Anterior Descending Coronary Artery Intracardiac injection Ventricular Function Left Biomaterials Internal medicine Coronary Circulation Medicine Humans Assisted Circulation Postoperative Period Aged Monitoring Physiologic Aged 80 and over business.industry Surgical wound General Medicine Blood flow Echocardiography Doppler Preload Catheter Ventricular assist device cardiovascular system Cardiology Female Heart-Assist Devices business Blood Flow Velocity |
| Zdroj: | Artificial organs. 14(5) |
| ISSN: | 0160-564X |
| Popis: | Transesophageal echocardiography (TEE) is an easy, noninvasive and reproducible method for evalua- tion of left ventricular function, coronary flow patterns, and intracardiac blood flow patterns during cardial assist. TEE facilitated better management of the patients with LVAD and gave us the various information: (a) Observ- ing the drawing catheter tip by TEE, it could be settled just above the mitral orifice to obtain the maximum by- pass flow; in addition, dislocation of the catheter tip could be easily diagnosed. (b) The intracardiac thrombus could be clearly detected by TEE; it was removed without com- plications, weaning from left ventricular assist device (LVAD). (c) The left ventricular wall motion was period- ically observed. The end systolic LV diameter (Ds) was decreasing and fractional shortening (%FS) was increas- ing as the natural heart recovery. Additionally, the pre- ejection period (PEP) and the ejection time (ET) were measured. The ratio of PEP/ET was decreasing gradually. Ds did not alter with preload change during on-off testing unlike the other parameters. Ds seems to be the most reliable parameter for the natural heart recovery within certain amounts of bypass flow. (d) The flow velocity in the left anterior descending coronary artery could be measured by transesophageal Doppler method; it was clinically shown that counterpulsation produced a larger amount of coronary blood flow than copulsation. Key Words: Transesophageal echocardiography-Left ven- tricular function. The clinical experiences of left ventricular assis- tance have been accumulated in the world. In our institute, left ventricular assist device (LVAD) was applied in four patients with low cardiac output af- ter open heart surgery, and one long-term survivor was obtained. It is very important to get informa- tion on intracardiac events for management of the patients with LVAD-for instance, natural heart re- covery, intracardiac thrombus formation, catheter tip position, coronary blood flow, and so on. For this purpose, transesophageal echocardiography (TEE) is a better diagnostic tool than a transtho- racic one, because the cardiac cavity can be clearly visualized without contamination at the surgical wound and cannulation sites. The present report is aimed at the presentation of the clinical effective |
| Databáze: | OpenAIRE |
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