Intraoperative contrast two-dimensional echocardiography. Evaluation of the presence and severity of XXXX during cardiac operations.

@entity1 @entity339 @entity413 @entity337
We have used contrast two-dimensional echocardiography in the intraoperative evaluation of @entity339 in 35 @entity1 undergoing cardiac operations. All of them underwent previous cardiac catheterization in order to document the presence and severity of regurgitation. With the pericardium open, a catheter was introduced into the left ventricle (to document @entity339 ) or into the ascending aorta (to document @entity337 ). The two-dimensional echocardiographic probe was placed on the anterior surface of the right ventricle to obtain a basal image, equivalent to a conventional parasternal longitudinal view. @entity413 in water (5 ml) was rapidly hand-injected through the catheter, while echocardiograms were recorded on videotape. The observation of contrast medium (microbubbles) flowing in the retrograde direction through the incompetent valve was carefully evaluated with the same scoring system used in the hemodynamic laboratory. In 34 cases there was agreement between angiographic and echocardiographic evaluation of the presence and severity of @entity339 . Only one case was evaluated as mild @entity337 by angiography and moderate @entity337 by echocardiography. There were no false positives or false negatives in the study. In view of the high degree of correlation between contrast two-dimensional echocardiography and hemodynamic data, we suggest that our method is an important tool for the cardiac surgeon. In addition, the present approach overcame the disadvantages of the conventional intraoperative methods, most of which are performed in a nonbeating or fibrillating heart.
