Department of Cardiac Anesthesia, Aster CMI, Bengaluru, Karnataka, India.
Department of Cardiac Anesthesia, AIIMS, Ansari Nagar, New Delhi, India.
Ann Card Anaesth. 2020 Oct-Dec;23(4):425-428. doi: 10.4103/aca.ACA_135_19.
Discrepancies have been reported in grading of severity of aortic stenosis. We propose to compare Aortic valve area by continuity equation, Dimensionless Index and Acceleration time/Ejection time in patients with documented severe aortic stenosis with normal left ventricular function by TEE after induction of anesthesia. This might give use insight about the best parameter we can rely on intra-operatively for decision making.
60 patients with severe AS undergoing elective cardiac surgery were enrolled in our study. Post intubation trans-thoracic echocardiography (TEE) was performed and above mentioned parameters was noted.
96.7 % of patients continued in severe AS category when AS was measured using AVA as echo parameter. So there is 3.3 % disparity. There was disparity in 13.3% of cases when DI was considered. And there was 43.3% disparity when AT/ET was considered.
Perioperative grading of aortic stenosis continues to be a challenge for cardiac anesthesiologists. Multiple echocardiographic parameters have to be considered. We have found AVA and DI to have less disparity compared to AT/ET.
主动脉瓣狭窄严重程度的分级存在差异。我们建议在麻醉诱导后通过 TEE 比较记录有严重主动脉瓣狭窄且左心室功能正常的患者的连续性方程、无量纲指数和加速度时间/射血时间的主动脉瓣口面积。这可能使我们对内窥镜手术中决策最依赖的最佳参数有更深入的了解。
我们的研究纳入了 60 例接受择期心脏手术的严重 AS 患者。在气管插管后进行经胸超声心动图（TEE）检查，并记录上述参数。
当使用超声心动图参数 AVA 测量 AS 时，96.7%的患者继续处于严重 AS 类别，因此存在 3.3%的差异。当考虑 DI 时，差异为 13.3%。当考虑 AT/ET 时，差异为 43.3%。
心脏麻醉师在围手术期对主动脉瓣狭窄的分级仍然是一个挑战。必须考虑多种超声心动图参数。我们发现 AVA 和 DI 的差异小于 AT/ET。
