Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Echocardiography in the perioperative period in patientswith coronary heart disease and postinfarction septal rupture

Authors: L.A. Вockeria, M.D. Alshibaya, N.O. Sokol’skaya, N.S. Kopylova, I.V. Slivneva

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russia, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2015; (): -

Quote as: Вockeria L.A., Alshibaya M.D., Sokol’skaya N.O., Kopylova N.S., Slivneva I.V.. Echocardiography in the perioperative period in patients with coronary heart disease and postinfarction septal rupture. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2015; 4: 34-40 (in Russ.)

Download
Full text:  

Abstract

Objective – to study features of functional condition of myocardium in patients with coronary artery disease and postinfarction septal rupture (PSR) in the perioperative period, using various technologies of echocardiography.

Material and methods. The study included 11 patients (9 men and 2 women, mean age was 57 ± 4 years) with a diagnosis of coronary artery disease, myocardial rupture interventricular septum (IVS), postinfarction left ventricle (LV) aneurysm. All patients were observed the symptoms of chronic heart failure NYHA IV functional class. All patients underwent surgery geometric reconstruction of LV, plastic PSR. Comprehensive echocardiography examination was performed preoperatively, intraoperatively and in the intensive care unit in the early stages after surgery. Used standard technology, the mode of 3-D transesophageal echocardiography.

Results. Before surgery all patients had dilatation of the left and right parts of the heart, significant pulmonary hypertension, severe impairment on the tricuspid valve. The average size of the defect in the area of post-infarction rupture of IVS was 14 ± 6 mm. As a result of operations, performed in the early postoperative period there was a significant decrease in LV volume characteristics, a tendency to normalization of the sizes of the right departments of heart, decreased the degree of pulmonary hypertension.

Conclusion. In patients with complicated forms of ischemic heart disease and postinfarction septal rupture in the early postoperative period, the normalization of the functional state of the myocardium of the right and left ventricle decreased volumetric and linear characteristics of left and right ventricle, decreasing the pressure in the right heart. Patients with complicated forms of ischemic heart disease and postinfarction ventricular septal rupture for an accurate diagnosis of the location and size of the defect standard Echocardiography examination is useful to complement the technology of threedimensional visualization. In order to assess the efficiency of the performed transactions using intraoperative transesophageal echocardiography.

References

  1. Чеишвили З.М. Хирургическое лечение постинфарктного разрыва межжелудочковой перегородки: Дис. … канд. мед. наук. М.; 2011.
  2. Алшибая М.М., Крымов К.В., Мусин Д.Е., Чеишвили З.М. Модифицированный способ хирургической коррекции постинфарктного разрыва межжелудочковой перегородки. Анналы хирургии. 2008; 2: 78–80.
  3. Сокольская Н.О., Сливнева И.В., Копылова Н.С., Толстихина А.А. Интраоперационная чреспищеводная эхокардиографическая диагностика ложной аневризмы левого желудочка. Грудная и сердечно-сосудистая хирургия. 2013; 1: 32–4.
  4. Бузиашвили Ю.И., Сигаев И.Ю., Мерзляков В.Ю. Факторы, предрасполагающие к разрыву межжелудочковой перегородки при остром инфаркте миокарда. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2005; 6 (2): 7–10.
  5. Бокерия Л.А., Алшибая М.М., Сокольская Н.О., Копылова Н.С., Наумова А.В. Интраоперационная оценка функционального состояния левого желудочка у больных ишемической болезнью сердца до и после геометрической реконструкции левого желудочка и аортокоронарного шунтирования. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2007; 8 (3): 40.
  6. Бокерия Л.А., Бузиашвили Ю.И., Ключников И.В. Ишемическое ремоделирование левого желудочка. М.: НЦССХ им. А.Н. Бакулева РАМН; 2002.
  7. Бокерия Л.А., Голухова Е.З. Осложнения острого инфаркта миокарда: клиника, диагностика, лечение. В кн.: Лекции по кардиологии. М.: НЦССХ им. А.Н. Бакулева РАМН; 2001; 2.
  8. Хапаев С.А. Хирургическое лечение осложнений инфаркта миокарда левого желудочка и межжелудочковой перегородки: Дис. … д-ра мед. наук. Но- восибирск; 2005.
  9. Жбанов И.В., Молочков А.В., Шабалкин Б.В. Реконструктивная хирургия осложненных форм ИБС. М.; 2013.
  10. Бокерия Л.А., Можина А.А. Постинфарктные разрывы межжелудочковой перегородки. М.: НЦССХ им. А.Н. Бакулева РАМН; 2005.
  11. Iwakii R., Nakagiri K., Muracami H., Morimoto N., Yoshida M., Mukohara N. Double-patch repair by bilateral ventriculotomy for postinfarction ventricular septal defect. J. Card. Surg. 2014; 29 (2): 181–5.
  12. Бокерия Л.А., Машина Т.В., Голухова Е.З. Трехмерная эхокардиография. М.: НЦССХ им. А.Н. Бакулева РАМН; 2002.
  13. Squeri A., Conti R., Bosi S. Ventricular septal rupture imaged with real-time three-dimensional transesophageal echocardiography: diagnosis at a glance. J. Cardiovassc. Med. 2014; 15 (1): 82–4.
  14. Little S.H., Ramasubbu K., Zoghbi W.A. Real-time 3-dimensional echocardiography demonstrates size and extent of acute left ventricular free wall rupture. J. Am. Soc. Echocardiogr. 2007; 20 (5): 538.e1–3.
  15. Scandura S., Ussia G., Caggegi A., Cammalleri V., Millan G., Tamburino C. Postinfarction ventricular septal defect: The role of three-dimensional echocardiography. Echocardiography. 2012; 29 (4): 107–9.
  16. Singh P., Mehta A., Nanda N. Live/real time threedimensional transthoracic echocardiographic findings in an adult with complete atrioventricular septal defect. Echocardiography. 2010; 27 (1): 87–90.
  17. Porter Т.R., Shillcutt S.K., Adams M.S., Desjardins G., Glas K.E., Oslon J.J. Guidelines for the use of echocardiography as a monitor for therapeutic intervention in adults: a report from the American Society of Echocardiography. J. Am. Soc. Echocardiogr. 2015; 28: 40–56.

 If you found mistakes, select text and press Alt+A