0
Articles |

Quantification of Aortic Stenosis in Mechanically Ventilated Patients Using Multiplane Transesophageal Doppler Echocardiography

Friedrich C. Blumberg; Michael Pfeifer; Stephan R. Holmer; Eckhard P. Kromer; Günter A.J. Riegger; Dietmar Elsner
Author and Funding Information

From the Klinik and Poliklinik für Innere Medizin II, University of Regensburg, Germany


1998 by the American College of Chest Physicians


Chest. 1998;114(1):94-97. doi:10.1378/chest.114.1.94
Text Size: A A A
Published online

Abstract

Study objectives: To evaluate the feasibility and accuracy of multiplane transesophageal Doppler echocardiographic assessment of the severity of aortic stenosis in mechanically ventilated patients using modified transgastral views of the left ventricular outflow tract and the aortic valve.

Design: A prospective study comparing the results of transesophageal echocardiography (TEE) with transthoracic echocardiography (TTE) and cardiac catheterization.

Setting: A university hospital.

Patients: Twenty-eight American Society of Anesthesiologists class III and IV patients with aortic stenosis undergoing elective cardiac surgery for valve replacement.

Interventions: Intubated and mechanically ventilated patients with aortic stenosis undergoing cardiac surgery for valve replacement were studied by multiplane transesophageal Doppler echocardiography to determine transvalvular pressure gradients (Bernoulli formula) and valve areas (continuity equation). These findings were compared with the respective preoperative data from TTE and cardiac catheterization.

Measurements and results: In 25 of 28 patients (89%), adequate transgastral Doppler recordings of the aortic jet could be obtained. The TEE measurements correlated well with the respective data obtained by TTE (maximal pressure gradient: r=0.93, p<0.0001, mean difference=5.9±5.8 mm Hg [mean±SD]; mean pressure gradient: r=0.91, p<0.0001, mean difference=5.4±4.6 mm Hg; aortic valve area: r=0.97, p<0.0001, mean difference=0.07±0.05 cm2) and cardiac catheterization (n=16) (maximal vs peak-to-peak pressure gradient: r=0.84, p<0.0001, mean difference=10.9±8.8 mmHg; mean pressure gradient: r=0.80, p<0.0002, mean difference=9.7±5.9 mm Hg; aortic valve area: r=0.84, p<0.0001, mean difference=0.1±0.08 cm2).

Conclusion: Multiplane transesophageal Doppler echocardiography offers an alternative approach for assessing the severity of aortic stenosis in mechanically ventilated patients in whom conventional TTE is not feasible.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543