Transthoracic echocardiography for the diagnosis of left ventricular thrombosis in the postoperative care unit 英文参考文献.docVIP

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Transthoracic echocardiography for the diagnosis of left ventricular thrombosis in the postoperative care unit 英文参考文献.doc

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Transthoracic echocardiography for the diagnosis of left ventricular thrombosis in the postoperative care unit 英文参考文献

Saranteasetal.CriticalCare2011,15:R54 /content/15/1/R54 RESEARCH OpenAccess Transthoracicechocardiographyforthediagnosis ofleftventricularthrombosisinthepostoperative careunit TheodosiosSaranteas1*,AnastasiaAlevizou1,MariaTzoufi1,FotiosPanou2,GeorgiaKostopanagiotou1 Abstract Introduction:Transthoracicechocardiography(TTE)isareliable,noninvasiveimagingmethodthatisusefulinthe evaluationofcardiovascularthrombosis.Weconductedaretrospectivestudyofalltheechocardiogramsfrom patientsinthepostoperativecareunittoassesstheroleofTTEinthrombusidentificationintheleftventricle. Methods:Thisretrospectivedatabaseevaluationincludedallechocardiogramsduringa14-monthperiod.The echocardiographicexaminationprotocolincludedthesubcostalfour-chamberview,theapicalfour-chamberview, theapicaltwo-chamberviewandtheparasternalview,alongthelongandshortaxesinbothspontaneouslyand mechanicallyventilatedpatients.Allechocardiogramswereobtainedwithinthe48hoursimmediatelyfollowing surgery. Results:Intotal,160postoperativeechocardiogramswereobtainedfrom160patientsandresultedinthe detectionoffivecasesofleftventricularthrombosis.Subgroupanalysisshowedthat21and35ofthe160patients examinedhadeitherdilatedorischemiccardiomyopathy,respectively.Inthesepatients,preoperative echocardiogramshadbeenobtainedrecentlypriortosurgeryandwerenegativeforleftventricularthrombus.In threeof35patientswithischemiccardiomyopathyandtwoof21patientswithdilatedcardiomyopathy,thrombus wasidentifiedintheleftventricle.Thethrombiweremobile,uncalcifiedandpedunculatedandwerelocatedin theapexoftheleftventricle.Inaddition,noclinicalconsequencesoftheleftventricularthrombiwererecorded. Conclusions:Low-flowconditionsinheartchambersduetoischemicordilatedcardiomyopathyinconjunction withthehypercoagulabilitycausedbyperioperativeprothromboticfactorsmayleadtothromboticeventsinthe leftventricle. Introduction employ TTEin theICUsetting[5-8]. Anesthesiologists Bothtransesophagealechocardiography(TEE)andtrans- with a cardiac and echocardiography ba