Orihashi K, Matsuura Y, Sueda T, Shikata H, Mitsui N, Sueshiro M
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Ann Thorac Surg. 1996 May;61(5):1377-80. doi: 10.1016/0003-4975(96)00082-3.
The clinical significance of pooled air detected by transesophageal echocardiography during open heart operations is not clear.
Thirty-eight consecutive patients undergoing an open heart operation or an operation on the ascending aorta were divided into two groups on the basis of the absence (group 1, n = 14) or presence (group 2, n = 24) of pooled air. They were examined for intramyocardial echo contrast, ST segment elevation, conduction disturbances, and regional wall motion abnormalities.
Echo contrast was found in no patient in group 1 and 66.7% of group 2 patients (p < 0.001). New regional wall motion abnormalities were detected in no patient in group 1 versus 33.3% of group 2 patients (p < 0.05), and ST segment elevation was seen in 33.3% of group 2 patients versus no group 1 patients (p < 0.05). Intramyocardial cardial echo contrast was newly detected after the appearance of pooled air more frequently in patients with ST segment elevation (p < 0.001). Atrioventricular block and sinus arrest appeared in 3 patients and 2 patients, respectively. Postoperative regional wall motion abnormalities were found in 25.0% of patients and were not closely related to intraoperative echo contrast findings.
Pooled air, which is often detected in open heart operation by means of transesophageal echocardiography, is related to several cardiac events, including ST segment elevation, conduction disturbances, and regional wall motion abnormalities, although most of these are transient.
经食管超声心动图检测到的心脏直视手术期间的积气的临床意义尚不清楚。
38例连续接受心脏直视手术或升主动脉手术的患者，根据有无积气分为两组（第1组，n = 14；第2组，n = 24）。对患者进行心肌内回声造影、ST段抬高、传导障碍和局部室壁运动异常检查。
第1组患者均未发现回声造影，而第2组患者中有66.7%出现回声造影（p < 0.001）。第1组患者均未检测到新的局部室壁运动异常，而第2组患者中有33.3%出现（p < 0.05）；第2组有33.3%的患者出现ST段抬高，第1组患者中未出现（p < 0.05）。ST段抬高的患者中，积气出现后更频繁地新检测到心肌内心脏回声造影（p < 0.001）。分别有3例和2例患者出现房室传导阻滞和窦性停搏。25.0%的患者术后出现局部室壁运动异常，且与术中回声造影结果无密切关系。
经食管超声心动图在心脏直视手术中常检测到的积气与多种心脏事件有关，包括ST段抬高、传导障碍和局部室壁运动异常，尽管其中大多数是短暂的。
