Mario Montealegre-Gallegos1, Feroze Mahmood2, Khurram Owais3, Phillip Hess3, Jayant S Jainandunsing4, Robina Matyal3. 1. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Anesthesia, Hospital México de la Caja Costarricense del Seguro Social, Universidad de Costa Rica, San José, Costa Rica. 2. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: fmahmood@bidmc.harvard.edu. 3. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. 4. Department of Anesthesiology and Pain Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
OBJECTIVE: To compare the determination of stroke volume (SV) and cardiac output (CO) using 2-dimensional (2D) versus 3-dimensional (3D) transesophageal echocardiography (TEE). DESIGN: Prospective observational study. SETTING: Tertiary care university hospital. PARTICIPANTS: 35 patients without structural valve abnormalities undergoing isolated coronary artery bypass grafting. INTERVENTIONS: Left ventricular outflow tract (LVOT) diameter determined with 2D TEE was used to estimate LVOT cross-sectional area (CSALVOT). LVOT area was measured directly with 3D TEE by planimetry on an en face view. SV and CO were calculated for both methods using the continuity equation. MEASUREMENTS AND MAIN RESULTS: The area of the LVOT differed significantly between methods, being significantly larger in the 3D method (3.57±0.70 cm(2)v 3.98±0.93 cm(2)) . This resulted in a 10% lower CO with the 2D method of LVOT area estimation. CONCLUSIONS: LVOT area is underestimated with the single- axis 2D method when compared with 3D planimetered area. This results in a CO that is approximately 10% lower with the 2D method.
OBJECTIVE: To compare the determination of stroke volume (SV) and cardiac output (CO) using 2-dimensional (2D) versus 3-dimensional (3D) transesophageal echocardiography (TEE). DESIGN: Prospective observational study. SETTING: Tertiary care university hospital. PARTICIPANTS: 35 patients without structural valve abnormalities undergoing isolated coronary artery bypass grafting. INTERVENTIONS: Left ventricular outflow tract (LVOT) diameter determined with 2D TEE was used to estimate LVOT cross-sectional area (CSALVOT). LVOT area was measured directly with 3D TEE by planimetry on an en face view. SV and CO were calculated for both methods using the continuity equation. MEASUREMENTS AND MAIN RESULTS: The area of the LVOT differed significantly between methods, being significantly larger in the 3D method (3.57±0.70 cm(2)v 3.98±0.93 cm(2)) . This resulted in a 10% lower CO with the 2D method of LVOT area estimation. CONCLUSIONS: LVOT area is underestimated with the single- axis 2D method when compared with 3D planimetered area. This results in a CO that is approximately 10% lower with the 2D method.