Loading...
Please wait, while we are loading the content...
Similar Documents
Intraoperative transesophageal Doppler color flow imaging used to guide patient selection and operative treatment of ischemic mitral regurgitation.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Bengtson, J. R. Bruijn, N. P. De Kisslo, Joseph |
| Copyright Year | 1991 |
| Abstract | BACKGROUND Intraoperative transesophageal Doppler color flow imaging (TDCF) affords the opportunity to assess mitral valve competency immediately before and after cardiopulmonary bypass (CPB). The purpose of this study was to assess the utility of TDCF to assist in the selection and operative treatment of ischemic mitral regurgitation (MR). METHODS AND RESULTS Two hundred forty-six patients undergoing surgery for ischemic heart disease were prospectively studied. All had preoperative cardiac catheterization. Catheterization and pre-CPB TDCF were discordant in their estimation of MR in 112 patients (46%). Compared with patients in whom both techniques agreed in estimation of MR, patients with discordance in MR were more likely to have had unstable clinical syndromes at the time of catheterization (79% versus 40%, p less than 0.05) or to have received thrombolytics (16% versus 8%, p less than 0.05). Pre-CPB TDCF resulted in a change in the operative plan with respect to the mitral valve in 27 patients (11%). Because less MR was found by TDCF than catheterization, 22 patients had only coronary bypass grafting when combined coronary bypass and mitral valve surgery had been planned. Because more MR was found by TDCF than catheterization, five patients had combined coronary bypass and mitral valve surgery when coronary bypass alone had been planned. Unsatisfactory results noted by TDCF following mitral valve surgery in five patients resulted in immediate corrective surgery. Cox regression analysis identified residual MR at the completion of surgery to be an important predictor of survival (chi 2 = 21.4) after surgery--more important than patient age (chi 2 = 8.3) or left ventricular ejection fraction (chi 2 = 5.3). CONCLUSIONS These results indicate that TDCF is useful in guiding patient selection and operative treatment of ischemic MR and that in such patients, intraoperative TDCF should be performed routinely. |
| Starting Page | 594 |
| Ending Page | 604 |
| Page Count | 11 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/84/2/594.full.pdf |
| PubMed reference number | 1860203v1 |
| Volume Number | 84 |
| Issue Number | 2 |
| Journal | Circulation |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Cardiopulmonary Bypass Coronary Artery Bypass Surgery Ejection fraction (procedure) Fibrinolytic Agents Heart Diseases Hypoxic-Ischemic Encephalopathy Mitral Valve Insufficiency Mitral Valve Prolapse Syndrome Myocardial Ischemia Patients Regurgitation Seventy Nine Unstable Medical Device Problem |
| Content Type | Text |
| Resource Type | Article |
