Matsumoto M, Oka Y, Strom J, Frishman W, Kadish A, Becker R M, Frater R W, Sonnenblick E H
Am J Cardiol. 1980 Jul;46(1):95-105. doi: 10.1016/0002-9149(80)90611-6.
Transesophageal M mode echocardiography was used for continuous monitoring of left ventricular dimensions in 21 patients (11 with valvular and 10 with coronary heart disease) undergoing open heart surgery. Echocardiograms were recorded in six stages of the procedure and simultaneous measurements of cardiac output (with dye dilution) and atrial pressures were made. Measurements of left ventricular diameters with the transesophageal technique correlated excellently with the corresponding measurements obtained with the standard parasternal method. In patients with volume overload, surgical correction was accompanied by a decrease in diastolic dimension, velocity of circumferential fiber shortening, mid wall stress and end-diastolic stiffness, and an increase in cardiac output. Pericardial and chest wall closures generally caused a significant decrease in cardiac output, and correlated with a decrease in diastolic diameter and an increase in the stiffness constant of the left ventricle. Thus, the decrease in cardiac output may have been due to decreased distensibility of the ventricular cavity secondary to mechanical restriction by the pericardium and chest wall. Pericardial opening caused a significant delay in septal motion that was reversed by closing the pericardium. This study confirms the validity of transesophageal echocardiography and its usefulness in monitoring changes in ventricular function during cardiac surgery.
经食管M型超声心动图用于对21例接受心脏直视手术的患者（11例瓣膜病患者和10例冠心病患者）的左心室尺寸进行连续监测。在手术的六个阶段记录超声心动图，并同时测量心输出量（采用染料稀释法）和心房压力。经食管技术测量的左心室直径与采用标准胸骨旁方法获得的相应测量值高度相关。在容量超负荷的患者中，手术矫正伴随着舒张期内径、圆周纤维缩短速度、室壁中层应力和舒张末期僵硬度的降低，以及心输出量的增加。心包和胸壁闭合通常导致心输出量显著降低，并与舒张期直径减小和左心室僵硬度常数增加相关。因此，心输出量降低可能是由于心包和胸壁的机械限制导致心室腔扩张性降低所致。心包打开导致室间隔运动明显延迟，心包闭合后这种延迟得以逆转。本研究证实了经食管超声心动图的有效性及其在心脏手术期间监测心室功能变化中的有用性。
