COMPARISON OF 2D TRANSESOPHAGEAL ECHOCARDIOGRAPHIC MEASUREMENT OF RIGHT VENTRICULAR FUNCTION WITH THERMODILUTION RIGHT VENTRICULAR EJECTION FRACTION

Abstract

Introduction: Function of the right ventricle (RV) is often an important issue during cardiac surgery. We prospectively compared two independent means of assessing RV function intraoperatively, 1) fractional area change (FAC) by 2D TEE from the mid esophageal RV long axis (LAX) and mid esophageal four chamber (4CH) views and 2) thermodilution right ventricular ejection fraction (REF) using a pulmonary artery catheter (PAC). Methods: 15 patients undergoing cardiac surgery had LAX and 4CH views of the RV obtained with a multiplane probe and stored to digital disk before CPB, after CPB, and/or after chest closure. The RV LAX view transected both the tricuspid valve and pulmonary valve annuli. REF was simultaneously measured with a REF PAC. End diastolic and end systolic areas of the RV for both TEE views were measured off line by a blinded investigator and FAC calculated. Regression analyses comparing RV LAX and 4CH FACs with REF were performed. Results: 33 observations with concurrent measurements of RV FAC LAX, RV FAC 4CH, and REF were obtained. Significant correlation of LAX FAC with REF was present (r =.57, p < 0.001) (Figure 1), while correlation of 4CH FAC with REF was absent (r =.10, p =.56) (Figure 2). RV FAC LAX and RV FAC 4CH were not significantly correlated (r =.33, p =.06).Figure 1Figure 2Conclusion: The RV FAC of the LAX view correlates with thermodilution REF much better than the FAC of the 4CH view. When using 2D TEE to assess RV function during cardiac surgery, the RV LAX view probably provides better information than the 4CH view.