What question did this study set out to answer?

To assess the feasibility and accuracy of transesophageal 3D-echocardiography for intraoperative right ventricular volume and function monitoring compared to fast-response thermodilution.

March 11, 2005European Journal of Cardio-Thoracic SurgeryOpen Access

Intraoperative assessment of right ventricular volume and function

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease (n=25). Intervention: Transesophageal 3D-echocardiography vs. Volumetric thermodilution. Primary outcome: Right ventricular ejection fraction (RVEF) (r=0.93, p=<0.01).

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Key result

Intraoperative transesophageal 3D-echocardiography correlated significantly with volumetric thermodilution for measuring right ventricular ejection fraction (r=0.93; P<0.01).

Why the study?

Does transesophageal 3D-echocardiography accurately assess right ventricular volume and function compared to volumetric thermodilution in patients undergoing cardiac surgery?

Population

25 patients with coronary artery disease undergoing cardiac surgery

Comparison

Transesophageal 3D-echocardiography with… vs Volumetric thermodilution using fast response…

Design

Cross-sectional

Follow-up

intraoperative

Authors

RDR. DeSimoneHeidelberg University IWIvo WolfTechnische Hochschule Mannheim BBBernd W. BöttigerUniversity of Cologne

Discussion

Member takes

Implication

Supports intraoperative 3D TEE for RV monitoring; leaves open prospective validation before clinical adoption.

Key Points

To assess the feasibility and accuracy of transesophageal 3D-echocardiography for intraoperative right ventricular volume and function monitoring compared to fast-response thermodilution.
Evaluated 25 patients with coronary artery disease undergoing cardiac surgery, collecting 68 simultaneous intraoperative measurements.
Assessed right ventricular end-diastolic volume, end-systolic volume, and ejection fraction via transesophageal 3D-echocardiography using Coons-Patches segmentation alongside fast-response thermistor pulmonary artery catheterization.
Right ventricular volumes showed no significant correlation between modalities, with volumetric thermodilution systematically overestimating volumes.
Right ventricular ejection fraction correlated strongly between 3D-echocardiography and thermodilution (r=0.93, y=0.2+0.80x, SEE=0.03, P<0.01), though thermodilution showed a systematic underestimation bias of +15.6% (precision +/-4.3%).
Patients with impaired left ventricular function exhibited significantly lower right ventricular ejection fraction compared to those with preserved function (44.1+/-4.6% vs. 55.1+/-3.9%, P<0.01).

Study Design

Type

Observational (n=25)

Multicenter

Structured PICO

Does transesophageal 3D-echocardiography accurately assess right ventricular volume and function compared to volumetric thermodilution in patients undergoing cardiac surgery?

Population

25 patients with coronary artery disease who underwent 68 simultaneous intraoperative measurements by 3D-echocardiography and thermodilution.

Exposure

Transesophageal 3D-echocardiography with 'Coons-Patches' segmentation technique

Comparator

Volumetric thermodilution using fast response thermistor pulmonary artery catheters

Outcome

Correlation and agreement of right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), and ejection fraction (RVEF)surrogate

Main Result

Effect estimate: r=0.93

p-value: p=<0.01

Intraoperative 3D transesophageal echocardiography is a feasible tool for assessing right ventricular ejection fraction, showing strong correlation with thermodilution.

Cite This Study

DeSimone et al. (2005) conducted an observational in Coronary artery disease (n=25). Transesophageal 3D-echocardiography vs. Volumetric thermodilution was evaluated on Right ventricular ejection fraction (RVEF) (r=0.93, p=<0.01). Intraoperative transesophageal 3D-echocardiography correlated significantly with volumetric thermodilution for measuring right ventricular ejection fraction (r=0.93; P<0.01).

synapsesocial.com/papers/6a965b1d0f79e4f014b2e5ea https://doi.org/10.1016/j.ejcts.2005.01.022

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Intraoperative assessment of right ventricular volume and function

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Intraoperative assessment of right ventricular volume and function

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

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