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. 2017 Dec;45(6):367-373.
doi: 10.5152/TJAR.2017.25483. Epub 2017 Nov 29.

Assessment of Left Ventricular Dimensions by Transoesophageal Echocardiography in Patients During Coronary Artery Bypass Surgery

Daniel Bolliger  1 , Corsin Poltera  1 , Albert T Cheung  2 , Pierre Couture  3 , Isabelle Michaux  4 , Jan Poelaert  5 , Sergey Preisman  6 , Karl Skarvan  1 , Giovanna Lurati Buse  1 , Manfred D Seeberger  7
Affiliations

Assessment of Left Ventricular Dimensions by Transoesophageal Echocardiography in Patients During Coronary Artery Bypass Surgery

Daniel Bolliger et al. Turk J Anaesthesiol Reanim. 2017 Dec.

Abstract

Objective: Normative values of left ventricular (LV) end-diastolic area and diameter (EDA and EDD) for intraoperative transoesophageal echocardiography (TEE) have not been established. We aimed to define the ranges of LV EDA and EDD for intraoperative TEE examinations in patients undergoing coronary artery bypass graft (CABG) surgery.

Methods: A MEDLINE search for studies reporting LV EDA and EDD in CABG patients was performed. Individual-level dataset from 333 anaesthetised and mechanically ventilated patients with preserved LV function (study population) were received from 8 studies. EDA and calculated EDD values in the study population were compared with summary mean EDD values obtained by transthoracic echocardiography (TTE) in 2 studies of 500 awake patients with coronary artery disease (CAD). Further, the influence of prespecified factors on EDD was evaluated through a multivariate regression model.

Results: LV EDA and EDD values measured by TEE in anaesthetised CABG patients were 16.7±4.7 cm2 and 4.6±0.6 cm, respectively. EDD values measured by TEE in anaesthetised patients were 10% to 13% less those measured by TTE in 2 studies of awake patients (p<0.001). Body surface area, age and fractional area change but not sex were factors that affected LV EDD.

Conclusion: LV EDD values measured by intraoperative TEE in anaesthetised and mechanically ventilated CABG patients were 10% to 13% less than those measured by TTE in awake CAD patients. This finding indicates that independent normative values specific for intraoperative TEE should be established for guiding intraoperative clinical decisions.

Keywords: Echocardiography; coronary artery bypass; coronary artery disease; echocardiography; intermittent positive-pressure ventilation; transoesophageal; transthoracic.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
End-diastolic Diameter Area (EDA) and Diameter (EDD) in Patients Undergoing CABG Surgery Mean±SD from the 8 studies (, –19) providing individual patient data are indicated. N/P: not published
Figure 2
Figure 2
End-diastolic Diameter (EDD) in the Study Population and in the Awake Population Calculated EDD (mean±SD) is lower in the anaesthetised study population with positive pressure ventilation than that in the awake population constituted from 2 studies (23, 24)
See this image and copyright information in PMC

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