Transesophageal echocardiography values for left ventricular end- diastolic area and pulmonary vein and mitral inflow Doppler velocities in patients undergoing coronary artery bypass graft surgery

Objective: To determine left ventricular end-diastolic area (EDA) and pulmonary vein and mitral inflow doppler velocities in patients undergoing coronary artery bypass graft (CABG) surgery using transesophageal echocardiography (TEE). To examine the effects of age, sex, and left ventricular function on these values. Design: Prospective observational study; all measurements performed before cardiopulmonary bypass. Setting: Tertiary referral teaching hospital. Participants: Eighty-six elective CABG surgery patients. Interventions: Intraoperative TEE was performed in all patients. Measurements and Main Results: The left ventricular EDA was measured at the midpapillary level, excluding the papillary muscles. Mean EDA for patients with normal left ventricular function, defined by fractional area change (FAC) 0.50 or greater, was 10.66 cm² and when indexed to body surface area was 5.6 cm²/m². The EDA was greater in patients with impaired left ventricular function (FAC < 0.50). Mean EDA was 14.84 cm², and EDA/body surface area was 7.8 cm²/m². In patients with FAC 0.50 or greater, mean peak pulmonary vein Doppler velocities were 46.10 cm/sec (systole), 31.71 cm/sec (diastole), and 1.50 (ratio systole to diastole). Mean peak mitral inflow Doppler velocities were 57.25 cm/sec (early diastole), 57.21 cm/sec (late diastole), and 1.10 (ratio early to late), and deceleration time was 216 msec. Age, sex, and left ventricular function were not significant predictors of Doppler variables. Conclusions: Values are presented for a predominantly white population undergoing cardiac surgery. Left ventricular dysfunction is associated with increased left ventricular EDA measurements. Copyright (C) 2000 by W.B. Saunders Company.