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Anesthesia & Analgesia, Vol 83, 1141-1148, Copyright © 1996 by International Anesthesia Research Society
Detection of intraoperative segmental wall-motion abnormalities by transesophageal echocardiography: the incremental value of additional cross sections in the transverse and longitudinal planes
K Rouine-Rapp, P Ionescu, M Balea, E Foster and MK Cahalan
Department of Anesthesia, University of California, San Francisco, USA.
Because biplane and multiplane transesophageal echocardiography (TEE) are
more complex and expensive than single-plane TEE, we performed this study
to determine whether the use of multiple single-plane (transverse) cross
sections is as reliable for detection of left ventricular segmental
wall-motion abnormalities (SWMA) as biplane TEE. We used biplane TEE to
acquire nine standard cross sections of the left ventricle in 41
consecutive adults undergoing cardiac or vascular surgery. Six of these
cross sections were in the transverse plane (i.e., achievable with
single-plane TEE) and three in the longitudinal plane (i.e., achievable
only with biplane or multiplane TEE). Each cross section was divided into
myocardial segments for analysis. A total of 1810 segments were analyzed by
independent investigators using a standardized evaluation system. Seventeen
percent of all SWMA detected in this study were in the midpapillary
transverse-plane cross section, an additional 48% in other transverse-plane
cross sections, and 35% exclusively in the longitudinal-plane cross
sections. Thus, most (65%), but not all, SWMA were in cross sections
achievable with single-plane TEE. We conclude that the MP-T cross section
should be the foundation for assessment of segmental function, but
additional cross sections in the transverse and longitudinal planes are
required for detection of the majority of segmental wall-motion
abnormalities.
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