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Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
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Descending aortic pulsed wave Doppler can predict changes in cardiac output during off-pump coronary artery bypass

Colin F Royse1, Alistair G Royse, Paul F Soeding

  • 1Department of Pharmacology, The University of Melbourne, Australia.

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
|December 16, 2003
PubMed

Insights

Doppler measurement of descending aortic flow using transesophageal echocardiography (TEE) can track cardiac output (CO) changes during off-pump coronary artery bypass graft surgery (OPCABG). This technique offers beat-to-beat assessment of hemodynamic status in OPCABG patients.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Off-pump coronary artery bypass graft surgery (OPCABG) involves significant hemodynamic fluctuations.
  • Monitoring cardiac output (CO) is crucial for managing these changes.
  • Transesophageal echocardiography (TEE) offers potential for real-time hemodynamic assessment.

Purpose of the Study:

  • To evaluate the utility of Doppler measurement of descending aortic flow (FlowDA) via TEE for beat-to-beat CO assessment during OPCABG.
  • To correlate FlowDA measurements with simultaneously measured CO using thermodilution.

Main Methods:

  • 26 OPCABG patients were studied.
  • Simultaneous measurements of CO (thermodilution) and FlowDA (TEE Doppler) were taken.
  • Measurements were performed at baseline and during grafting to LAD, Cx, and RCA territories.

Main Results:

  • CO significantly decreased from baseline during grafting to all territories (P<0.001).
  • Individual correlation between CO and FlowDA was poor.
  • In a subgroup (n=16), changes in FlowDA mirrored changes in CO (P=0.062).

Conclusions:

  • Doppler assessment of descending aortic flow via TEE can track CO changes during OPCABG.
  • This method provides valuable beat-to-beat hemodynamic monitoring in OPCABG.
  • TEE-derived FlowDA is a promising tool for intraoperative hemodynamic management.

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