Intraoperative transesophageal echocardiographic assessment of left ventricular Tei index in congenital heart disease.
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Date
2015-04
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Abstract
Background: Use of the Tei index has not been described to assess myocardial function before or after
surgery in pediatric patients. This study was designed to evaluate the left ventricular (LV) function using the
Tei index pre‑ and post‑cardiopulmonary bypass in patients with lesion that result in a volume loaded right
ventricle (RV). Methods: Retrospective data on 55 patients who underwent repair of a cardiac defect were
analyzed. Patients with volume overload RV (n = 15) were compared to patients without volume overload but
with other cardiac defects (n = 40). We reviewed pre‑ and post‑operative LV myocardial performance index (Tei
index). Tei index was obtained from transesophageal Doppler echocardiogram. Results: Patients with right
heart volume overload, the mean preoperative Tei index was 0.6, with a postoperative mean decrease of
0.207 (P = 0.014). Patients without right heart volume overload, the mean preoperative Tei was 0.48 with
no significant postoperative change (P = 0.82). Conclusion: Pre‑ and post‑operative transesophageal
echocardiogram assessment provides an easy and quick way of evaluating LV function intra‑operatively
using LV Tei index. Preoperative LV Tei index was greater in the RV volume overload defects indicating
diminished LV global function. This normalized in the immediate postoperative period, implying an immediate
improvement in LV function. In patients without right heart volume load, consist of other cardiac defects,
demonstrated no changes in the pre‑ and post‑operative LV Tei. This implies that LV function was similar
after the surgery.
Description
Keywords
Congenital heart defect, Transesophageal echocardiogram, Tei index
Citation
Sivanandam Shanthi, Wey Andrew, Louis James St. Intraoperative transesophageal echocardiographic assessment of left ventricular Tei index in congenital heart disease.Annals of Cardiac Anaesthesia. 2015 Apr; 18(2): 198-201.