Evaluation Of Right Ventricular Function Of Patient Undergoing Mitral Valve Replacement With Omni-directional M-mode Echocardiograph During Operation

Objective：1. To disscuss the value that evaluating right ventricular (RV) function withomni-directional M-mode (OME) echocardiograph in patient undergoing mitralvalve replacement.2. Discuss the correlation between OME and other Quantitative ultrasoundtechnology.Methods：1. Object:30cases of control group,58patients with pure mitral stenosis werereceived mitral valve replacement.2. Equipment: LEJ-2type omni-directional M-mode echocardiography, GE Vivid-7Dimension color ultrasound imaging system with Echo PAC work staion.3. Measurement:(1)Images sequences captured in three cardiac cycles by TEEseparately before skin incision (pre-operation) and right after the sternum closing(post-operation). Using quantitative tissue velocity imaging(QTVI) andOmni-directional M-mode echocardiography(OME) to measure the peak systolicvelocity (Sa) of tricuspid annular respectively. The peak systolic longitudinalstrain of right ventricular myocardial were measured by twodimensionspeckle-tracking imaging(2D-STI).30normal subjects were measuredwall peak systolic velocity on papillary muscle level at the left ventricularshort-axis view by OME and anatomic M-mode echocardiography(AMM).(2)Compare the variation of pre-and-postoperative peak systolic velocity oftricuspid annulus(Sa) measured by OME with that measured by QTVI. Analysethe correlativity of Sa and PASP. At last, analyse the correlativity of resultsderived from OME and QTVI, OME and2D-STI, OME and AMM.Results:1. In most of the tricuspid annular sites, the postoperative peak systolic velocity rose (P<0.01).2. The peak systolic velocity of tricuspid annular and the systolic pulmonary arterypressure were of negative correlation (r=-0.85, P<0.01).3. The difference of OME and QTVI had no statistical significance (P>0.05), whilethe results had obtained good correlation between them (r=0.94，P<0.01).Theresult of OME and2D-STI had obtained good correlation between them (r=0.95，P<0.01).The difference of wall peak systolic velocity measured by OME andAMM had no statistical significance (P>0.05), while the results had obtained goodcorrelation between them (r=0.81, P<0.01).Conclusions:OME can provide precise and instant valuation of right ventricular function changeduring the process of mitral valve replacement. It is to provide cardiac surgeon andanesthesiologist basis for taking active measures to manage respiratory, adjust thedosage of drugs, control pulmonary artery pressure, regulate volume load, amelioratethe right ventricular function, prevent postoperative complications, etc. in theperioperative period. It is of magnitude importance for improving the success rate ofthe cardiac surgery and for evaluating the patients’ prognosis. OME is of significantclinical value for intraoperative monitoring and for assessing right ventricularfunction after mitral valve replacement.