Intraoperative contrast transesophageal echocardiography using Albunex

This study was designed to investigate the effect of administration of the contrast material Albunex on intraoperative contrast transesophageal echocardiography for patients with mitral valve disease or coronary artery disease. We studied nine patients scheduled for elective coronary artery bypass grafting (CABG group) and nine patients scheduled for elective mitral valve replacement (MVR group), and used a transesophageal echocardiography probe and an echocardiographic system. During the period of stable hemodynamics before the start of cardiopulmonary bypass, Albunex in doses of 0.1 ml·kg^-1 was injected at a rate of about 1 ml·s^-1 from either the peripheral venous line or the distal lumen of the pulmonary arterial catheter, and the effect on contrast was compared. This effect was semiquantitatively assessed by using a grading scale from 0 to 3, with 0 indicating an absence of opacification and 3, full opacification of the cavities examined. In the CABG group, contrast resulting from administration of Albunex from the pulmonary arterial catheter was significantly better than that from the peripheral venous line, whereas in the MVR group, no improvement was found. Furthermore, when it was administered into the pulmonary artery, the effect on contrast for the MVR group was significantly lower than that for the CABG group. The efficacy rate of intraoperative contrast transesophageal echocardiography using Albunex was relatively low, and appeared to be affected by pulmonary circulation or many other factors such as the method of administration, including the route and injection pressure.