Two-dimensional ultrasound and cardiac operations.

Two-dimensional ultrasound was employed for qualitative and quantitative studies during cardiac operations in 74 patients. A gas-sterilized phased-array transducer applied directly to the anterior surface of the heart produced high-quality images without a water path or other special manipulations. The techniques employed were successful in demonstrating alterations in cardiac anatomy associated with valve disease and cardiac tumors. Continuous clouds of microbubbles ejected from the left ventricle immediately following cardiopulmonary bypass were detected in 42% of 45 patients studied. Measurement of short-axis area change during systole proved useful for evaluation of intraoperative changes in left ventricular function. In the perioperative period, with the chest closed, the method detected increasing left ventricular mass during transplant rejection and was useful for monitoring changes in left ventricular performance when image quality was sufficient. The capabilities and limitations of this technique for special studies during cardiac operations should be familiar to surgeons with access to the method.