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Related Experiment Video

Updated: Jul 19, 2026

Multimodality Diagnosis of Mesenteric Ischemia
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Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

Segmental wall-motion abnormalities after an arterial switch operation indicate ischemia.

Kathryn Rouine-Rapp1, Kenneth P Rouillard, Wanda Miller-Hance

  • 1Department of Anesthesia, University of California-San Francisco, 94143-0648, USA. rouinerk@anesthesia.ucsf.edu

Anesthesia and Analgesia
|October 24, 2006
PubMed
Summary

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Segmental wall motion abnormalities (SWMA) detected during arterial switch operations may indicate myocardial ischemia in neonates. Persistent SWMA correlate with higher cardiac troponin I levels and ECG evidence of ischemia, suggesting a link to reduced heart muscle blood flow.

Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Echocardiography

Background:

  • Arterial switch operation (ASO) is a critical procedure for neonates with transposition of the great arteries.
  • Assessing intraoperative myocardial ischemia is crucial for patient outcomes.
  • Segmental wall motion abnormalities (SWMA) on echocardiography may indicate myocardial ischemia.

Purpose of the Study:

  • To determine if intraoperative SWMA during ASO represent myocardial ischemia in neonates.
  • To correlate SWMA with biochemical markers and electrocardiographic findings of ischemia.

Main Methods:

  • Prospective study of 29 neonates undergoing ASO.
  • Intraoperative transesophageal echocardiography (TEE) to assess SWMA.
  • Serial cardiac troponin I (cTnI) measurements.

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  • Postoperative Holter monitoring and ECGs.

    • Main Results:

    • SWMA were present at chest closure in 15 neonates.
    • Neonates with persistent SWMA had significantly more segments involved (P > 0.001).
    • Persistent SWMA correlated with higher postoperative cTnI levels (P = 0.02) and increased ECG evidence of ischemia.

    Conclusions:

    • Persistent SWMA after ASO are associated with myocardial ischemia.
    • SWMA and elevated cTnI levels are predictive of postoperative SWMA.
    • Further research is needed to link intraoperative ischemia to long-term outcomes.