Eltzschig Holger K, Kallmeyer Ian J, Mihaljevic Tomislav, Alapati Sailaja, Shernan Stanton K
Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
J Cardiothorac Vasc Anesth. 2003 Aug;17(4):422-9. doi: 10.1016/s1053-0770(03)00145-9.
More than a decade before the introduction of intraoperative transesophageal echocardiography (TEE), epicardial echocardiography was already in use as a diagnostic imaging modality to assist cardiac surgeons and anesthesiologists with clinical decision making. Although TEE has since become increasingly more popular, epicardial echocardiography may be the most convenient intraoperative imaging technique when TEE probe placement cannot be performed or is contraindicated. The authors developed a comprehensive examination protocol for the intraoperative interrogation of cardiac structures using an epicardial/epiaortic echocardiographic approach.
Retrospective analysis of patient's medical records.
Single-center academic tertiary care hospital.
Patients undergoing cardiac surgery.
A total of 10 echocardiographic views were obtained for imaging cardiac structures, the ascending aorta, and proximal aortic arch. The described imaging planes permit the evaluation of ventricular performance, valvular function, cardiac structural abnormalities, and aortic disease.
A comprehensive epicardial/epiaortic echocardiographic examination was performed in 20 patients undergoing cardiac surgery requiring a full sternotomy. The described imaging planes were obtained in all patients in less than 8 minutes (range, 3.5-8 minutes; mean, 5.5 minutes).
The present manuscript delineates a protocol for performing a comprehensive, intraoperative epicardial/epiaortic echocardiographic examination. Echocardiographic imaging planes of cardiac and aortic anatomy are described. This protocol may be useful for cardiac surgeons and anesthesiologists seeking to use this technique as a cardiac imaging modality that is complementary to TEE.
在术中经食管超声心动图（TEE）应用的十多年前，心外膜超声心动图就已作为一种诊断成像方式，用于辅助心脏外科医生和麻醉医生进行临床决策。尽管自那时起TEE越来越普及，但当无法进行TEE探头放置或存在禁忌证时，心外膜超声心动图可能是最便捷的术中成像技术。作者制定了一项综合检查方案，用于使用心外膜/主动脉外膜超声心动图方法在术中对心脏结构进行检查。
对患者病历进行回顾性分析。
单中心学术三级护理医院。
接受心脏手术的患者。
共获取10个超声心动图视图，用于成像心脏结构、升主动脉和主动脉弓近端。所描述的成像平面可用于评估心室功能、瓣膜功能、心脏结构异常和主动脉疾病。
对20例接受需要正中开胸心脏手术的患者进行了全面的心外膜/主动脉外膜超声心动图检查。所有患者均在不到8分钟（范围3.5 - 8分钟；平均5.5分钟）内获得了所描述的成像平面。
本手稿描述了一种进行全面的术中的心外膜/主动脉外膜超声心动图检查的方案。描述了心脏和主动脉解剖结构的超声心动图成像平面。该方案可能对寻求将此技术作为与TEE互补的心脏成像方式的心脏外科医生和麻醉医生有用。
