Real-time 3-dimensional transesophageal echocardiography assessment of left ventricular shape and function after surgical remodelling
1Faculty of Medicine, University J.J. Strossmayer Osijek, HR-31000 Osijek Clinical Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Dubrava, Zagreb
DOI: 10.22514/SV131.032017.2 Vol.13,Issue S1,May 2017 pp.20-23
Published: 08 May 2017
Real-time three dimensional transoesoph-ageal echocardiography (RT 3D-TEE) may better reflect left ventricle (LV) shape and function than cconventional 2D-TEE. The goal of this study was to evaluate the ad-vantages of 3D analysis in shape assessment and to quantify the LV volume by ejection fraction (EF) measurement, after LV surgi-cal remodelling.
In a prospective manner, twenty consecu-tive coronary surgery patients with LV an-teroapical aneurysm and functional mitral regurgitation were analyzed by 2D- and thereafter by 3D- TEE before and after surgery. The key intraoperative inclusion criteria was a LVEF < 30% confirmed by intraoperative 3D-TEE immediately before surgical remodeling.
Before surgery, the geometry of post infarc-tion aneurysm shows negative curvatures of the antero-basal and infero-apical seg-ment and the apex of LV is shifted clock-wise, towards the mitral valve. Surgery had significantly reduced the LV volumes and the LVEF had increased by 13.3% as recorded by 2D-TEE and by 18.3% as as-sessed by 3D-TEE quantification (p < 0.001 for both). Accordingly, the longitudinal plane had been shortened, the apex was now shifted anti-clockwise towards the aorta and the inferior region had taken a more important function of the LV. Signifi-cantly lower values were observed in the EF measurement with 3D- vs 2D-TEE before remodelling (22.3 vs. 29.7%, p = 0.048).
Improvement of LV function occurred due to the increased systolic contraction of the inferior region after remodelling in pa-tients with postinfarction aneurysm.
intraoperative transesophageal echocardiography (TEE), real-time three di-mensional TEE (RT-3D TEE), left ventricle, cardiac surgery
STJEPAN BARISIN. Real-time 3-dimensional transesophageal echocardiography assessment of left ventricular shape and function after surgical remodelling . Signa Vitae. 2017. 13(S1);20-23.
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