Feasibility of measuring pulmonary venous blood flow spectrum by transesophageal ultrasound in evaluating intraoperative left atrial pressure in pediatric patients with complex congenital heart disease
10.3760/cma.j.cn131073.20210814.00215
- VernacularTitle:经食管超声测量肺静脉血流频谱评估复杂先天性心脏病患儿术中左心房压力的可行性
- Author:
Hui WANG
1
;
Weisong ZUO
;
Jian FEI
;
Xuming MO
;
Shan ZHONG
Author Information
1. 南京医科大学附属儿童医院麻醉科，南京 210008
- Keywords:
Ultrasonography;
Pulmonary veins;
Atrial pressure;
Heart defects, congenital
- From:
Chinese Journal of Anesthesiology
2022;42(2):195-198
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility of measuring pulmonary venous blood flow spectrum by transesophageal ultrasound in assessing intraoperative left atrial pressure (LAP) in pediatric patients with complex congenital heart disease.Methods:Twenty-five pediatric patients with complex congenital heart disease of either sex, aged < 3 yr, of American Society of Anesthesiologists physical status Ⅲ or Ⅳ, with New York Heart Association class Ⅲ or Ⅳ, undergoing surgery with general anesthesia and requiring LAP monitoring during surgery, were selected.Transesophageal echocardiography was used to record the left pulmonary venous blood flow spectrum during surgery.S wave velocity (PV S), D wave velocity (PV D), AR wave velocity (PV AR), and deceleration time of pulmonary venous diastolic flow (DT D) were measured at 15 min after termination of CPB.The ratio of S wave peak velocity to D wave peak velocity (S/D ratio) was calculated.Measurement was carried out for 3 consecutive cardiac cycles, and the average value was calculated.The LAP was simultaneously measured through the left atrial piezometer.Pearson correlation analysis was performed between PV S, PV D, PV AR, DT D, S/D ratio and LAP. Results:PV S, PV D, PV AR and S/D ratio had no correlation with LAP ( r=-0.06, 0.21, 0.19, -0.38, respectively, P>0.05), while DT D was negatively correlated with LAP ( r=-0.84, P<0.05). Conclusions:DT D measured by transesophageal ultrasound can be used to evaluate intraoperative LAP in pediatric patients with complex congenital heart disease.
