[Transesophageal echocardiography during intraoperative evaluation of central hemodynamics in surgical treatment of ischemic heart disease].

Whether transesophageal echocardiography may be used in the assessment of central hemodynamics has been studied in 40 patients undergoing direct cardiac revascularization in extracorporeal circulation. Changes in the mean values of end diastolic area (EDA) and end-diastolic anteroposterior dimensions, end-systolic myocardial stress (ESMS), anteroposterior size shortening fraction (SF), and area decrease fraction (ADF) of cross left ventricular section are outlined in the paper. It has been indicated that at the beginning of extracorporeal circulation EDA showed, on an average, a 22% decrease (p less than 0.001), after its termination, it practically returned to the baseline values. ESMS remained high at the beginning of the operation, but at the onset of extracorporeal circulation it also dropped by 26% (p less than 0.001), being rather low until the end of the operation. The highest SF and ADF values were observed after termination of extracorporeal circulation. The changes in the parameters in question were found in hypovolemia and decreased myocardial contractility. The application of transesophageal echocardiography along with direct blood pressure monitoring correctly and fully assesses central hemodynamics.