Feasibility of intraoperative three-dimensional transesophageal echocardiography in the evaluation of right ventricular volumes and function in patients undergoing cardiac surgery

Laura Fusini, Gloria Tamborini, Paola Gripari, Francesco Maffessanti, Valeria Mazzanti, Manuela Muratori, Luca Salvi, Erminio Sisillo, Enrico G. Caiani, Francesco Alamanni, Cesare Fiorentini, Mauro Pepi

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Abstract

Background: The aim of this study was to test the feasibility of the assessment of right ventricular (RV) volumes and function using real-time three-dimensional (3D) transesophageal echocardiographic (TEE) imaging in patients undergoing cardiac surgery. Methods: One hundred-fifty surgical patients were enrolled: 65 undergoing mitral valve repair, 10 undergoing mitral valve and tricuspid valve repair, four with congenital heart disease, two undergoing Jarvik implantation, 13 undergoing aortic valve surgical replacement, and 56 undergoing transcatheter aortic valve implantation. Real-time 3D TEE acquisition for RV evaluation was performed before and after the surgical procedure and compared with standard two-dimensional multiplane TEE measurements. In a subgroup of 81 patients, 3D transthoracic echocardiographic imaging was also performed. RV volumetric quantification was performed for all data using dedicated software. Results: Three-dimensional RV analysis was feasible in 98.7% in the preoperative TEE data set and in 92.7% in the postoperative TEE data set. Agreement between 3D transthoracic and transesophageal echocardiography for end-diastolic volume (r = 0.98; 95% confidence interval [CI], -0.2 ± 13.6 mL), end-systolic volume (r = 0.97; 95% CI, -2.1 ± 10.2 mL), ejection fraction (r = 0.77; 95% CI, 1.8 ± 8.2%), and stroke volume (r = 0.91; 95% CI, 2.0 ± 12.9 mL) was significant. RV parameters were highly reproducible in patients with both normal and dilated RV volumes. Conclusions: Intraoperative 3D TEE assessment of RV volumes and function is feasible in patients with normal and dilated right ventricles, with good correlation between 3D transthoracic echocardiographic and TEE RV parameters. These measurements could improve the quantitative evaluation of RV function during cardiac surgery.

Original languageEnglish
Pages (from-to)868-877
Number of pages10
JournalJournal of the American Society of Echocardiography
Volume24
Issue number8
DOIs
Publication statusPublished - Aug 2011

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Three-Dimensional Echocardiography
Right Ventricular Function
Transesophageal Echocardiography
Thoracic Surgery
Confidence Intervals
Mitral Valve
Tricuspid Valve
Aortic Valve
Stroke Volume
Heart Ventricles
Echocardiography
Heart Diseases
Software

Keywords

  • Cardiac Surgery
  • Right ventricle
  • Three-dimensional transesophageal echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{c1ed580aa55242e7a7c80571a7f5b701,
title = "Feasibility of intraoperative three-dimensional transesophageal echocardiography in the evaluation of right ventricular volumes and function in patients undergoing cardiac surgery",
abstract = "Background: The aim of this study was to test the feasibility of the assessment of right ventricular (RV) volumes and function using real-time three-dimensional (3D) transesophageal echocardiographic (TEE) imaging in patients undergoing cardiac surgery. Methods: One hundred-fifty surgical patients were enrolled: 65 undergoing mitral valve repair, 10 undergoing mitral valve and tricuspid valve repair, four with congenital heart disease, two undergoing Jarvik implantation, 13 undergoing aortic valve surgical replacement, and 56 undergoing transcatheter aortic valve implantation. Real-time 3D TEE acquisition for RV evaluation was performed before and after the surgical procedure and compared with standard two-dimensional multiplane TEE measurements. In a subgroup of 81 patients, 3D transthoracic echocardiographic imaging was also performed. RV volumetric quantification was performed for all data using dedicated software. Results: Three-dimensional RV analysis was feasible in 98.7{\%} in the preoperative TEE data set and in 92.7{\%} in the postoperative TEE data set. Agreement between 3D transthoracic and transesophageal echocardiography for end-diastolic volume (r = 0.98; 95{\%} confidence interval [CI], -0.2 ± 13.6 mL), end-systolic volume (r = 0.97; 95{\%} CI, -2.1 ± 10.2 mL), ejection fraction (r = 0.77; 95{\%} CI, 1.8 ± 8.2{\%}), and stroke volume (r = 0.91; 95{\%} CI, 2.0 ± 12.9 mL) was significant. RV parameters were highly reproducible in patients with both normal and dilated RV volumes. Conclusions: Intraoperative 3D TEE assessment of RV volumes and function is feasible in patients with normal and dilated right ventricles, with good correlation between 3D transthoracic echocardiographic and TEE RV parameters. These measurements could improve the quantitative evaluation of RV function during cardiac surgery.",
keywords = "Cardiac Surgery, Right ventricle, Three-dimensional transesophageal echocardiography",
author = "Laura Fusini and Gloria Tamborini and Paola Gripari and Francesco Maffessanti and Valeria Mazzanti and Manuela Muratori and Luca Salvi and Erminio Sisillo and Caiani, {Enrico G.} and Francesco Alamanni and Cesare Fiorentini and Mauro Pepi",
year = "2011",
month = "8",
doi = "10.1016/j.echo.2011.05.002",
language = "English",
volume = "24",
pages = "868--877",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
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number = "8",

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TY - JOUR

T1 - Feasibility of intraoperative three-dimensional transesophageal echocardiography in the evaluation of right ventricular volumes and function in patients undergoing cardiac surgery

AU - Fusini, Laura

AU - Tamborini, Gloria

AU - Gripari, Paola

AU - Maffessanti, Francesco

AU - Mazzanti, Valeria

AU - Muratori, Manuela

AU - Salvi, Luca

AU - Sisillo, Erminio

AU - Caiani, Enrico G.

AU - Alamanni, Francesco

AU - Fiorentini, Cesare

AU - Pepi, Mauro

PY - 2011/8

Y1 - 2011/8

N2 - Background: The aim of this study was to test the feasibility of the assessment of right ventricular (RV) volumes and function using real-time three-dimensional (3D) transesophageal echocardiographic (TEE) imaging in patients undergoing cardiac surgery. Methods: One hundred-fifty surgical patients were enrolled: 65 undergoing mitral valve repair, 10 undergoing mitral valve and tricuspid valve repair, four with congenital heart disease, two undergoing Jarvik implantation, 13 undergoing aortic valve surgical replacement, and 56 undergoing transcatheter aortic valve implantation. Real-time 3D TEE acquisition for RV evaluation was performed before and after the surgical procedure and compared with standard two-dimensional multiplane TEE measurements. In a subgroup of 81 patients, 3D transthoracic echocardiographic imaging was also performed. RV volumetric quantification was performed for all data using dedicated software. Results: Three-dimensional RV analysis was feasible in 98.7% in the preoperative TEE data set and in 92.7% in the postoperative TEE data set. Agreement between 3D transthoracic and transesophageal echocardiography for end-diastolic volume (r = 0.98; 95% confidence interval [CI], -0.2 ± 13.6 mL), end-systolic volume (r = 0.97; 95% CI, -2.1 ± 10.2 mL), ejection fraction (r = 0.77; 95% CI, 1.8 ± 8.2%), and stroke volume (r = 0.91; 95% CI, 2.0 ± 12.9 mL) was significant. RV parameters were highly reproducible in patients with both normal and dilated RV volumes. Conclusions: Intraoperative 3D TEE assessment of RV volumes and function is feasible in patients with normal and dilated right ventricles, with good correlation between 3D transthoracic echocardiographic and TEE RV parameters. These measurements could improve the quantitative evaluation of RV function during cardiac surgery.

AB - Background: The aim of this study was to test the feasibility of the assessment of right ventricular (RV) volumes and function using real-time three-dimensional (3D) transesophageal echocardiographic (TEE) imaging in patients undergoing cardiac surgery. Methods: One hundred-fifty surgical patients were enrolled: 65 undergoing mitral valve repair, 10 undergoing mitral valve and tricuspid valve repair, four with congenital heart disease, two undergoing Jarvik implantation, 13 undergoing aortic valve surgical replacement, and 56 undergoing transcatheter aortic valve implantation. Real-time 3D TEE acquisition for RV evaluation was performed before and after the surgical procedure and compared with standard two-dimensional multiplane TEE measurements. In a subgroup of 81 patients, 3D transthoracic echocardiographic imaging was also performed. RV volumetric quantification was performed for all data using dedicated software. Results: Three-dimensional RV analysis was feasible in 98.7% in the preoperative TEE data set and in 92.7% in the postoperative TEE data set. Agreement between 3D transthoracic and transesophageal echocardiography for end-diastolic volume (r = 0.98; 95% confidence interval [CI], -0.2 ± 13.6 mL), end-systolic volume (r = 0.97; 95% CI, -2.1 ± 10.2 mL), ejection fraction (r = 0.77; 95% CI, 1.8 ± 8.2%), and stroke volume (r = 0.91; 95% CI, 2.0 ± 12.9 mL) was significant. RV parameters were highly reproducible in patients with both normal and dilated RV volumes. Conclusions: Intraoperative 3D TEE assessment of RV volumes and function is feasible in patients with normal and dilated right ventricles, with good correlation between 3D transthoracic echocardiographic and TEE RV parameters. These measurements could improve the quantitative evaluation of RV function during cardiac surgery.

KW - Cardiac Surgery

KW - Right ventricle

KW - Three-dimensional transesophageal echocardiography

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U2 - 10.1016/j.echo.2011.05.002

DO - 10.1016/j.echo.2011.05.002

M3 - Article

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JO - Journal of the American Society of Echocardiography

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