Why the study?
Does the simultaneous use of transesophageal echocardiography and measurement of myocardial pH differentiate between myocardial stunning and irreversible myocardial infarction in patients with severe postcardiotomy ventricular dysfunction?
Does the simultaneous use of transesophageal echocardiography and measurement of myocardial pH differentiate between myocardial stunning and irreversible myocardial infarction in patients with severe postcardiotomy ventricular dysfunction?
Simultaneous TEE and myocardial pH measurement may help differentiate stunned from infarcted myocardium intraoperatively, guiding the appropriate use of ventricular assist devices.
May inform intraoperative viability assessment in postcardiotomy shock; leaves open whether combined TEE-pH monitoring alters VAD decisions or outcomes.
The ability to differentiate intraoperatively between myocardial stunning, which is reversible, and irreversible myocardial infarction has major implications because it provides a rational approach to the use or withholding of ventricular assist devices in patients with severe postcardiotomy ventricular dysfunction. Two illustrative cases are presented.
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Khuri et al. (1994) studied this question.
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