Cardiac function assessed by transesophageal echocardiography during pectus excavatum repair

Ann Thorac Surg. 2010 Jan;89(1):240-3. doi: 10.1016/j.athoracsur.2009.06.126.

Abstract

Background: We assessed end-diastolic right ventricular (RV) dimensions and left ventricular (LV) ejection fraction by use of intraoperative transesophageal echocardiography before and after surgical correction of pectus excavatum in adults.

Methods: A prospective study was conducted including 17 patients undergoing surgical correction of pectus excavatum according to the technique of Ravitch-Shamberger between 1999 and 2004. Intraoperative transesophageal echocardiography was performed under general anesthesia before and after surgery to assess end-diastolic RV dimensions and LV ejection fraction. The end-diastolic RV diameter and area were measured in four-chamber and RV inflow-outflow view, and the RV volume was calculated from these data. The LV was assessed by transgastric short-axis view, and its ejection fraction was calculated by use of the Teichholz formula.

Results: The end-diastolic RV diameter, area, and volume all significantly increased after surgery (mean values +/- SD, respectively: 2.4 +/- 0.8 cm versus 3.0 +/- 0.9 cm, p < 0.001; 12.5 +/- 5.2 cm(2) versus 18.4 +/- 7.5 cm(2), p < 0.001; and 21.7 +/- 11.7 mL versus 40.8 +/- 23 mL, p < 0.001). The LV ejection fraction also significantly increased after surgery (58.4% +/- 15% versus 66.2% +/- 6%, p < 0.001).

Conclusions: Surgical correction of pectus excavatum according to Ravitch-Shamberger technique results in a significant increase in end-diastolic RV dimensions and a significantly increased LV ejection fraction.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Echocardiography, Transesophageal / methods*
  • Female
  • Funnel Chest / physiopathology
  • Funnel Chest / surgery*
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Prospective Studies
  • Recovery of Function
  • Stroke Volume
  • Thoracotomy / methods*
  • Ventricular Function, Left / physiology*
  • Ventricular Function, Right / physiology*
  • Young Adult