Intraoperative perfusion echocardiography

Abstract

The ability to assess perfusion intraoperatively should enable end-organ evaluation of the effects of therapeutic choices and provide a basis for understanding the mechanisms of disease. Several experimental techniques for assessment of tissue perfusion are being evaluated; contrast echocardiography appears to be adaptable to the perioperative setting because of its portability and relatively modest cost. With further improvements in commercial ultrasound imaging devices and ultrasonic contrast agents, intraoperative contrast echocardiography may prove to be a technique for quantitation of tissue perfusion. Contrast echocardiography is currently being used intraoperatively to assess cardioplegia distribution, coronary bypass graft patency, and coronary artery collateral vessel distribution. In addition, relative change in renal blood flow can be assessed during renal transplant surgery. With continued advancement of ultrasound technology providing linear (or known) acoustic signal response and wider dynamic range for detection of small and large concentrations of contrast agents, tissue blood flow may soon be evaluated with even greater precision.