Importance of intraoperative transesophageal echocardiography during coronary artery surgery without cardiopulmonary bypass

Importance of intraoperative transesophageal echocardiography during coronary artery surgery without cardiopulmonary bypass

Autor Moises, V. A. Google Scholar
Mesquita, C. B. Google Scholar
Campos, O. Google Scholar
Andrade, J. L. Google Scholar
Bocanegra, José Autor UNIFESP Google Scholar
Andrade, JCS Google Scholar
Buffolo, E. Google Scholar
Carvalho, A. C. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo The goal of this study was to assess left ventricular segmental wall motion (SWM) abnormalities during coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), and its impact on the immediate postoperative outcome. Transesophageal echocardiography was used intraoperatively in 27 patients (mean age 57 years) who had CABG without CPB. Images obtained with a 5-MHz biplane transesophageal echocardiographic probe in the transgastric and transesophageal planes were recorded before, during, and after 48 coronary artery clampings for saphenous vein or internal mammary artery anastomosis. Transthoracic echocardiography was performed 1 day before surgery and on the seventh postoperative day. During the 48 coronary artery clamplngs, 31 (64%) new SWM abnormalities were found. At the time of chest closure, complete recovery occurred in 16 (50%) segments, partial recovery in 10 (33%), and no recovery in 5 (17%). On the seventh postoperative day the flew SW abnormalities persisted in all 5 segments without recovery at the end of the surgery and in 2 of 10 (20%)segments with partial recovery(group 1). Group 1 had higher variation on the echocardiographic point score index between the beginning and end of surgery, higher enzymatic levels, more ST-T changes on the electrocardiogram, and more clinical problems than group 2 (patients without new SWM abnormalities on the seventh postoperative day) (P < .05). We concluded that flew SWM abnormalities of the left ventricle occur during CABG without CPB as assessed by intraoperative transesophageal echocardiography. Persistence of these abnormalities at the end of surgery may be a predictor of SWM dysfunction and clinical problems in the immediate postoperative period.
Idioma Inglês
Data de publicação 1998-12-01
Publicado em Journal of the American Society of Echocardiography. St Louis: Mosby-year Book Inc, v. 11, n. 12, p. 1139-1144, 1998.
ISSN 0894-7317 (Sherpa/Romeo, fator de impacto)
Publicador Mosby-year Book Inc
Extensão 1139-1144
Fonte http://dx.doi.org/10.1016/S0894-7317(98)80009-6
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000077499000007
Endereço permanente http://repositorio.unifesp.br/handle/11600/25989

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