Transesophageal tissue Doppler echocardiography for evaluation of myocardial function during aortic valve replacement.
OBJECTIVE
Tissue Doppler imaging is an evolving ultrasound technology that, compared with traditional echocardiography, promises reduced subjectivity in the assessment of myocardial performance and contributes new information on myocardial function. The aim of this study was to evaluate the feasibility of transesophageal tissue Doppler imaging in the setting of aortic valve replacement.


METHODS
Feasibility study.


METHODS
Aarhus University Hospital, Denmark.


METHODS
Twelve patients with isolated aortic valve stenosis or combined ischemic cardiomyopathy and aortic valve stenosis scheduled for elective aortic valve replacement were included.


METHODS
Transgastric short-axis recordings of the left ventricular anterior wall were performed using Vivid-7 technology (GE Healthcare, Horten, Norway) with activated tissue Doppler imaging before sternotomy, at intervals during progressive withdrawal of cardiopulmonary bypass, and within 1 hour after transfer to the postoperative care unit. Data were postprocessed for assessment of systolic radial function with the tissue Doppler modalities, tissue velocity, end-systolic strain rate, and strain by using dedicated software.


RESULTS
Accurate tissue Doppler data were obtained for all patients at baseline and postoperatively. During the gradual loading of the left ventricle, velocity measurements were all obtained accurately, whereas 8% to 25 % of strain and strain-rate measurements were considered unreliable. Immediately after cardioplegia, 33% to 58% of measurements were unreliable.


CONCLUSIONS
Transesophageal tissue Doppler is feasible in the intraoperative setting, although unreliable data acquisition occurs during cardiopulmonary bypass. Tissue Doppler is a promising quantitative tool for monitoring of myocardial function within minutes and may also reveal new information on myocardial function in patients undergoing thoracic surgery.
Norrild
Kathrine
K
Department of Anaesthesiology, Skejby Hospital, Aarhus University, Copenhagen, Denmark. kathrinenorrild@dadlnet.dk
Pedersen
Troels Fogh
TF
Sloth
Erik
E
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015150:Echocardiography, Doppler / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged