TY - JOUR
T1 - Intraoperative 2-dimensional echocardiography
T2 - Ejection of microbubbles from the left ventricle after cardiac surgery
AU - Rodigas, Paul C.
AU - Meyer, Frances J.
AU - Haasler, George B.
AU - Dubroff, Jerome M.
AU - Spotnitz, Henry M.
PY - 1982/11
Y1 - 1982/11
N2 - Although the presence of entrapped air in the left ventricle at surgery has long been a concern, its prevalence and clinical significance are unknown. Two-dimensional echocardiography provides a unique means for observing intracardiac microbubbles intraoperatively. Accordingly, intraoperative 2-dimensional echocardiograms obtained in 79 patients immediately after cardiopulmonary bypass were examined for the presence of microbubbles. Left ventricular microbubbles were detected in 14% of coronary artery bypass operations (n = 22), 50% of multiple valve replacements (n = 8), 67% of single valve replacements (n = 58), and 100% of atrial septal defect closures (n = 4), left atrial myxoma resections (n = 2), and mitral commissurotomies (n = 2). Microbubbles were not observed in patients undergoing coronary artery bypass with valve replacement (n = 4) or with removal of left ventricular aneurysm (n = 1). Continuous ejection of microbubbles from the left ventricle was frequently noted for extended periods of time and, although no patient in this study showed evidence of gross neurologic dysfunction, the possibility of subclinical organ damage exists. We conclude that 2-dimensional echocardiography is useful for detection of intracardiac microbubbles and therefore may be instrumental in their elimination.
AB - Although the presence of entrapped air in the left ventricle at surgery has long been a concern, its prevalence and clinical significance are unknown. Two-dimensional echocardiography provides a unique means for observing intracardiac microbubbles intraoperatively. Accordingly, intraoperative 2-dimensional echocardiograms obtained in 79 patients immediately after cardiopulmonary bypass were examined for the presence of microbubbles. Left ventricular microbubbles were detected in 14% of coronary artery bypass operations (n = 22), 50% of multiple valve replacements (n = 8), 67% of single valve replacements (n = 58), and 100% of atrial septal defect closures (n = 4), left atrial myxoma resections (n = 2), and mitral commissurotomies (n = 2). Microbubbles were not observed in patients undergoing coronary artery bypass with valve replacement (n = 4) or with removal of left ventricular aneurysm (n = 1). Continuous ejection of microbubbles from the left ventricle was frequently noted for extended periods of time and, although no patient in this study showed evidence of gross neurologic dysfunction, the possibility of subclinical organ damage exists. We conclude that 2-dimensional echocardiography is useful for detection of intracardiac microbubbles and therefore may be instrumental in their elimination.
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U2 - 10.1016/0002-9149(82)90431-3
DO - 10.1016/0002-9149(82)90431-3
M3 - Article
C2 - 7137040
AN - SCOPUS:0020418397
SN - 0002-9149
VL - 50
SP - 1130
EP - 1132
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 5
ER -