Transesophageal Doppler Echo Monitoring of Cardiac Function During Assist Circulation
Weaning a patient from mechanical assist circulation (MAC) at the optimal time is a determining factor for his survival. However, information available to determine the optimal timing is usually limited in an intensive care unit (ICU), because the patient is supported by a heavy circulation assist system, which prevents him or her being transfered to the cardiac examination laboratories. Transthoracic echocardiography may be effective in evaluating perioperative cardiac function in some cases, but in an ICU the echo penetration is usually poor because the patients are on ventilators and receiving some positive end-expiratory pressure assistance. Transesophageal echocardiography (TEE) can usually give a reasonably good echo window even in such a circumstance in ICU, because with this technique there is no obstruction by the lung, sternum, or ribs and so distinct and stable images can be obtained in the deeper area of the thoracic cavity [1, 7]. The purpose of this study was to evaluate the clinical feasibility and effectiveness of TEE, including color flow mapping Doppler , in management of patients during MAC.
Unable to display preview. Download preview PDF.
- 3.Kyo S, Handa N, Takamoto S, Adachi H, Ueda K, Yokote Y, Omoto R (1988). The reversed shunt flow through the patent foramen ovale in left ventricular assist circulation: evaluation by transesophageal color Doppler echo. Jpn J Artif Organs 17:888–891.Google Scholar
- 5.Kyo S, Takamoto S, Matsumura M, Asano H, Yokote Y, MotoyamaT, Omoto R (1987). Immediate and early postoperative evaluation of results of cardiac surgery by transesophageal two-dimensional Doppler echocardiography. Circulation 76(Suppl V):113.Google Scholar
- 6.Magovern JA, Pae WE Jr, Pichenbacher WE, Pierce WS (1986). The importance of a foramen ovale in left ventricular assist pumping. Trans Am Soc Artif Intern Organs 32:449–453.Google Scholar
- 8.Neya K, Takamoto S, Harada M, Nakano R, Kyo S, Yokote Y, Omoto R (1989). Effect of left ventricular assist device and intra-aortic balloon pumping on the coronary flow. Jpn J Artif Organs (in press) 18(2):503–506.Google Scholar
- 9.Omoto R, Yokote Y, Takamoto S, Kyo S, Ueda K, Asano H, Namekawa K, Kasai C, Kondo Y, Koyano A (1984). The development of real-time two-dimensional Doppler echocardiography and its clinical significance in acquired valvular disease with special reference to the evaluation of valvular regurgitation. Jpn Heart J 25:325–340.PubMedCrossRefGoogle Scholar