title: The importance of transesophageal echocardiography during surgery of the thoracic aorta.
abstract: OBJECTIVE
  To assess left ventricular dimensions and cardiac output during thoracic and thoracoabdominal aortic aneurysm repair.
  
  
  METHODS
  Nine patients undergoing thoracic and thoracoabdominal aneurysm repair using direct cross-clamping without shunt or by-pass were studied prospectively. Prior to, during cross-clamping (XC) and after declamping left ventricular cross-sectional areas were monitored with transesophageal echocardiography. A pulmonary artery catheter was used for measurements of cardiac output with the thermodilution technique.
  
  
  RESULTS
  Cardiac output increased 43% from baseline during XC (p < 0.01) and was still 55% above baseline at declamping (p < 0.05). Left ventricular end-systolic inner area was reduced 32% during XC (p < 0.01). Pulmonary artery pressures and central venous pressure increased during declamping (p < 0.05). Heart rate increased 38% from 66 beats/ min to 92 beats/min (p < 0.01) and was still 30% elevated at declamping (p < 0.01).
  
  
  CONCLUSIONS
  During thoracic aortic XC, cardiac output is increased and left ventricular end-systolic dimension is reduced. TEE is a valuable supplement to pressure measurements for the evaluation of cardiac function during surgery of the thoracic aorta.
authors.affiliation: Department Anaesthesiology, University Hospital of Trondheim, Norway.
authors.forename: P
authors.initials: P
authors.lastname: Aadahl
authors.forename: O D
authors.initials: OD
authors.lastname: Saether
authors.forename: S
authors.initials: S
authors.lastname: Aakhus
authors.forename: K
authors.initials: K
authors.lastname: Bjørnstad
authors.forename: T
authors.initials: T
authors.lastname: Strømholm
authors.forename: H O
authors.initials: HO
authors.lastname: Myhre
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology; D015996:Survival Rate