Intraoperative assessment of the stunned versus infarcted myocardium with the simultaneous use of transesophageal echocardiography and the measurement of myocardial pH: two case studies.
The ability to differentiate intraoperatively between myocardial stunning, which is reversible, and irreversible myocardial infarction has major implications because it provides a rational approach to the use or withholding of ventricular assist devices in patients with severe postcardiotomy ventricular dysfunction. Two illustrative cases are presented.
Khuri
S F
SF
Department of Surgery, Brockton/West Roxbury VA Medical Center, MA 02132.
Farhat
T
T
Zankoul
F
F
Healey
N A
NA
Zolkewitz
M A
MA
Treanor
P R
PR
Birjiniuk
V
V
Pietro
D
D
Murkerjee
A
A
D000368:Aged; D006348:Cardiac Surgical Procedures; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017682:Myocardial Stunning / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D009206:Myocardium / Q000737:chemistry; D016277:Ventricular Function, Left