Evaluation Of Left Ventricular Function Of Patient With Mitral Value Replacement Using Omni-directional M-mode Echocardiograph During Operation

Objective:1.To investigate the value of evaluating left ventricular myocardial function of patients with omni-directional M-mode echocardiograph(OME) during mitral valve replacement. 2.Discuss the correlation between OME and Quantitative issue velocity imaging ultrasound technology. 3.Discuss the correlation between the time cardio pulmonary bypass(CPB) during operation and LVEF(left ventricular ejection fraction), CO(cardiac output), CI(cardiac index) respectively.Methods:1.Object: 55 cases have accepted pure mitral valve replacement in patients. 2.Equipment: LEJ-2 type omni-directional M-mode echocardiography, GE Vivid-7 Dimension color ultrasound imaging system with Echo PAC work station. 3.Measurement:(1) Images sequences captured by TEE pre-operation and post-operation in three cardiac cycles. Using omni-directional M-mode echocardiography(OME) and quantitative tissue velocity imaging(QTVI) to measure the peak systolic velocity(Sa),displacement(Ds) and the time to peak velocity(Ts) of mitral annular respectively.(2) Compared the variation of pre-and-post operative peak systolic velocity(Sa)、displacement(Ds) and the time to peak velocity(Ts) of mitral annular measured by OME with those by QTVI. Analysed the correlativity of results derived from OME and QTVI. At last, analysed the the time CPB during operation and LVEF, CO, CI.(3) With omni-directional M-mode echocardiographymeasured changes of Sa, Ds and Ts at the end of initial perfusion during CPB and pulled aortic cannulation before fully open perfusion time in mitral annular each site.Results:1. The LVD,LVEDV and LVEF were increased after value replacement compared with preoperative(p<0.05), and the LAD was reduced than before, the difference had statistical significance(p<0.01). 2. The postoperative peak systolic velocity(Sa)、displacement(Ds) have rose,the time to peak velocity(Ts) of the most mitral annular sites reduced than preoperation(p <0.05). 3. The difference of OME and QTVI had no statistical significance(p >0.05), while the results had obtained good correlation between them,Sa(r=0.653, p<0.01),Vs(r=0.594, p<0.01)and Ts(r=0.549, p<0.01). 4.The time of CPB during operation and LVEF, CO, CI were negative correlation(r=-0.708、-0.734、-0.657, p<0.01). 5. The peak systolic velocity(Sa)、displacement(Ds) and the time to peak velocity(Ts) of the mitral annular sites fully open perfusion time was reduced compared with initial infusion the end of CPB, the difference had statistical significance(p<0.05).Conclusions:OME can access to all segments of the left ventricular wall motion information accurately and in real-time is instantly evaluation of mitral valve replacement in patients with myocardial function of simple and effective method. It is to provide a useful basis for cardiac surgeons and anesthesists in taking active measures to adjust the dosage of drugs and the time of operation, regulate volume load, ameliorate the left ventricular function,prevent postoperative complications.With the result that,OME is significantly clinical value for intraoperative monitoring and for assessing immediately left ventricular myocardial function after mitral valve replacement.