The diagnostic validity of digitally captured intraoperative transesophageal echocardiography examinations compared with analog recordings: A pilot study.
BACKGROUND
Digital acquisition and storage of echocardiographic studies offer many advantages over analog recordings, but the amount of computer memory required may be large. "Computer compression" of data is done by machines with various algorithms. "Clinical compression" involves limiting the recordings to 1-beat loops, and although it is commonly used, its diagnostic validity has not been demonstrated in the operating room.


METHODS
This prospective pilot study looked at 51 patients undergoing transesophageal echocardiography during cardiac surgery. During continuous videocassette recording, we captured digital loops to demonstrate wall motion abnormalities, ventricular systolic function, aortic insufficiency, and mitral regurgitation. Experts reviewed the loops and tapes. We then compared the diagnoses from the 2 methods.


RESULTS
There were major differences in the diagnosis of wall motion between loops and tapes in only 3.4% of myocardial segments. No major differences were seen in the diagnosis of systolic function, aortic insufficiency, or mitral regurgitation in any patients.


CONCLUSIONS
We conclude that clinical compression is a suitable method to compress data in the operating room. Large numbers of patients are required to definitively demonstrate the small differences.
Lambert
A S
AS
Department of Anesthesia and the Department of Medicine, Division of Cardiology, University of California, San Francisco.
Miller
J P
JP
Foster
E
E
Schiller
N B
NB
Cahalan
M K
MK
D016009:Chi-Square Distribution; D017548:Echocardiography, Transesophageal; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007432:Intraoperative Period; D015588:Observer Variation; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D012984:Software; D014743:Videotape Recording