title: Intraoperative Right Ventricular Fractional Area Change Is a Good Indicator of Right Ventricular Contractility: A Retrospective Comparison Using Two- and Three-Dimensional Echocardiography.
abstract: OBJECTIVE
  Intraoperative two-dimensional echocardiography is technically challenging, given the unique geometry of the right ventricle (RV). It was hypothesized that the RV fractional area change (RVFAC) could be used as a simple method to evaluate RV function during surgery. Therefore, the correlation between the intraoperative RVFAC and the true right ventricular ejection fraction (RVEF), as measured using newly developed three-dimensional (3D) analysis software, was evaluated.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Patients who underwent cardiac surgery with transesophageal echocardiography monitoring between March 2014 and June 2014.
  
  
  METHODS
  None.
  
  
  RESULTS
  Sixty-two patients were included in this study. After the exclusion of poor imaging data and patients with arrhythmias, 54 data sets were analyzed. RVFAC was measured by one anesthesiologist during surgery, and full-volume 3D echocardiographic data were recorded simultaneously. The 3D data were analyzed postoperatively using off-line 3D analysis software by a second anesthesiologist, who was blinded to the RVFAC results. The mean RVFAC was 38.8% ± 8.7%, the mean RVEF was 41.4% ± 8.3%, and there was a good correlation between the RVFAC and the RVEF (r(2) = 0.638; p<0.0001).
  
  
  CONCLUSIONS
  The RVFAC was well-correlated with the RVEF calculated using 3D echocardiography; therefore, RVFAC provides a simple and useful method for anesthesiologists to evaluate intraoperative RV function.
authors: Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: imada@anes.med.osaka-u.ac.jp.
authors: Tatsuyuki
authors: T
authors: Imada
authors: Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Takahiko
authors: T
authors: Kamibayashi
authors: Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Chiho
authors: C
authors: Ota
authors: Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Sho
authors: S
authors: Carl Shibata
authors: Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Takeshi
authors: T
authors: Iritakenishi
authors: Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Yoshiki
authors: Y
authors: Sawa
authors: Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Yuji
authors: Y
authors: Fujino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000592:standards*; D004452:Echocardiography / Q000379:methods / Q000592:standards; D019560:Echocardiography, Three-Dimensional / Q000379:methods / Q000592:standards*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods / Q000592:standards*; D009200:Myocardial Contraction / Q000502:physiology*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: RVFAC; right ventricular ejection fraction; right ventricular fractional area change; right ventricular function; three-dimensional echocardiography