To Value Myocardial Movement Synchronization Of Patients With Valvular Operation And Pacemaker By TEE

[Objective]To evaluate the synchronization movement of the left and right ventricle of the patients during valvular operation and temporary pacemaker implantation by transesophageal echocardiography(TEE).[Methods]Forty-six patients with bicuspid valve or aortic valve abnormality were divided into pacemakers working group(22 cases)and pacemaker reserve group(24 cases)according to the working status of the pacemaker after valvular operation.Ejection fraction(EF),cardiac output(CO),global circumferential strain of the left ventricle and right ventricle(S-LV and S-RV),left ventricular synchronization time standard deviation(LVSDt),right ventricular synchronization time standard deviation(RVSDt),tricuspid annular plane systolic excursion(TAPSE),right ventricular fractional area change(RVFAC),velocity-time integral of the right ventricular outflow tract(VTI-RVOT)and maximal velocity(Vmax)were detected by TEE preoperation(TO),15 min(T1)and 45 min(T2)after the stop of cardiopulmonary bypass.The results were analyzed and compared.[Results]In pacemaker group,S-LV and TAPSE were decreased at T1 and T2 compared with TO,RVFAC and S-RV were decreased at T2 compared with TO,there was significant difference(P<0.05).VTI-RVOT and Vmax in the two groups were increased at T1 and T2 compared with TO,there was significant difference(P<0.05).Compared with pacemaker reserve group,S-LV was decreased at T1 and T2,LVSDt was increased at T1,TAPSE,S-RV were decreased at T2,RVFAC was decreased at T1 in pacemaker group,there was significant difference(P<0.05).[Conclusion]Left and right ventricular contraction movement and left ventricular synchronization movement in pacemaker working group are decreased after valve surgery,which indicates that drug treatment is needed.TEE can monitor the myocardial contraction real-timely,dynamically and intuitively,and it can help to evaluate the synchronization.