Correlation between Intraoperative Direct and Transesophageal Echocardiographic Assessment of Right Ventricular Outflow Tract Pressure Gradient in Patients Undergoing Tetralogy of Fallot Repair

Authors

  • Fatima Amin National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Abdul Sattar Shaikh National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Sohail Khan Bangash National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Amber Kamran National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Nida Rafique National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Mujeeb Ur Rehman National Institute of Cardiovascular Diseases, Karachi, Pakistan
  • Najma Patel National Institute of Cardiovascular Diseases, Karachi, Pakistan

DOI:

https://doi.org/10.47144/phj.v56i1.2484

Abstract

Objectives: The objective of this study was to determine the correlation between intraoperative direct (needle) and transesophageal echocardiographic (TEE) assessment of right ventricular outflow tract (RVOT) pressure gradient in patients undergoing Tetralogy of Fallot (TOF) repair.

Methodology: A total of 100 patients underwent for TOF repair were included. After completion of surgery and successful weaning from cardiopulmonary bypass, the TEE derived RVOT gradients were obtained from, the midesophageal ascending aortic short axis (AA Sax) view, upper esophageal aortic arch short axis (Arch Sax) view and trans-gastric RV outflow (TG RV outflow) view. Direct (needle) derived pressures from right ventricular (RV) and pulmonary artery (PA) were obtained by surgeon using a saline filled pressure transducer system. Correlation coefficient was computed between intraoperative direct and TEE assessment of RVOT gradient was evaluated.

Results: In the sample of 100 patients, 41% were females and median age was 8 [5-11] years. The TEE derived RVOT gradients obtained in AA Sax, Arch Sax and TG RV outflow view were 26.46±6.98, 26.60±6.55, and 22.64±6.21 mmHg, respectively. Intraoperative RVOT pressure gradient was 19.05±8.9 mmHg. The correlation between intraoperative direct (needle) and TEE assessment of RVOT pressure gradient obtained in AA Sax, Arch Sax, and TG RV outflow view were 0.588 (p<0.001), 0.283 (p<0.001), and 0.383 (p<0.001), respectively.

Conclusion: Intraoperative TEE assessment of RVOT pressure gradient showed a moderate correlation with the direct (needle) assessment. The ascending aorta short axis view was found to be the superior esophageal view.

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Published

2023-04-01

How to Cite

1.
Amin F, Shaikh AS, Bangash SK, Kamran A, Rafique N, Rehman MU, Patel N. Correlation between Intraoperative Direct and Transesophageal Echocardiographic Assessment of Right Ventricular Outflow Tract Pressure Gradient in Patients Undergoing Tetralogy of Fallot Repair. Pak Heart J [Internet]. 2023Apr.1 [cited 2024Oct.5];56(1):92-6. Available from: https://pakheartjournal.com/index.php/pk/article/view/2484

Issue

Vol. 56 No. 1 (2023): Pakistan Heart Journal

Section

Original Article

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Copyright (c) 2023 Pakistan Heart Journal

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