title: Dynamic quantitative echocardiographic evaluation of mitral regurgitation in the operating department.
abstract: Hemodynamic modifications induced by general anesthesia could lead to underestimation of mitral regurgitation (MR) severity in the operating department and potentially serious consequences. The intraoperative severity of MR was prospectively compared with the preoperative baseline evaluation using dynamic quantitative transesophageal echocardiography in 25 patients who were stable with MR 2/4 or greater undergoing coronary bypass, mitral valve operation, or both. Significant changes in the severity of MR using transesophageal echocardiographic criteria occurred after the induction of general anesthesia and with phenylephrine. Quantitative transesophageal echocardiographic evaluation of MR using effective orifice area and vena contracta, and the use of phenylephrine challenge, were useful to avoid underestimating MR severity in the operating department.
authors.affiliation: Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gisbert
authors.forename: Vicky
authors.initials: V
authors.lastname: Soulière
authors.forename: André Y
authors.initials: AY
authors.lastname: Denault
authors.forename: Denis
authors.initials: D
authors.lastname: Bouchard
authors.forename: Pierre
authors.initials: P
authors.lastname: Couture
authors.forename: Michel
authors.initials: M
authors.lastname: Pellerin
authors.forename: Michel
authors.initials: M
authors.lastname: Carrier
authors.forename: Sylvie
authors.initials: S
authors.lastname: Levesque
authors.forename: Anique
authors.initials: A
authors.lastname: Ducharme
authors.forename: Arsène J
authors.initials: AJ
authors.lastname: Basmadjian
mesh_terms: D000293:Adolescent; D000328:Adult; D013504:Cardiovascular Surgical Procedures / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*; D009873:Operating Rooms / Q000379:methods; D011379:Prognosis; D012720:Severity of Illness Index; D025321:Surgery, Computer-Assisted / Q000379:methods*