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Journal of Cardiovascular Medicine and Surgery

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Tissue Doppler Imaging and Wall Acceleration During Weaning from Cardiopulmonary Bypass (CPB)

Rashmi Arunkumar Kotecha , Prasanna Simha Mohan Rao , Rashmi Arunkumar Kotecha , Sunil P.K. , Parimala Prasanna Simha , Sadiq Sheriff ,

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Journal of Cardiovascular Medicine and Surgery 5(1):p 20-25, January-March 2019. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.5119.4

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Abstract

Background: Tissue Doppler Imaging (TDI) provides information of LV function. This study was designed to assess TDI and wall motion characteristics while weaning from CPB to determine the effect of volume loading on locoregional contractility. Methods: Fifty one cardiac surgical patients were evaluated. All patients requiring elective surgery and cross clamp period of less than 120 min. They underwent epicardial / transesophageal echocardiography while coming off CPB, during progressive loading of the heart. TDI and wall acceleration at mid papillary level (anteroseptal and posterior wall) were recorded. Patients with LV dysfunction and AR were excluded. Results: Mean ant wall ‘e’ and ‘a’ waves (early diastolic and late diastolic) values increased from 100% CPB to 50% on pump (‘e’: p value=0.03, ’a’: p value=0.002) whereas for‘s’ wave (systolic) value, significant increase was seen at 100% CPB to 75% on pump (p value=0.001). Mean post wall ‘a’ and ‘s’ wave values increased from 100% CPB to 75% CPB whereas ‘e’ increased significantly after going off pump (‘a’: p value=0.001 , ’s’: p value =0.014 ‘e’: p value =0.001). Mean wall acceleration of anteroseptal wall increased significantly from 100% CPB to 50% on pump (p value =0.001), whereas mean post wall acceleration did not increase significantly througout weaning from CPB but it was persistently higher than anteroseptal wall at all levels. There was no statistical difference for heart rate while coming off bypass. Conclusion: There is maximum increase in myocardial contractility (systolic and diastolic) due to preload augmentation between 75% to 50% of CPB while coming off bypass. There is minimal augmentation in contractility thereafter.

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.5119.4

Keywords

Tissue Doppler Imaging; Cardio Pulmonary Bypass; Wall Acceleration.   

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