OBJECTIVE
To evaluate the dynamics of intraventricular and intraaortic blood flows in ascending aorta dissection according to the data of transesophageal echocardiography (TEE) in the intraoperative period.
MATERIAL AND METHODS
During the study, 36 patients with dissecting aneurysms of the ascending aorta with mean age 52.4±7.5 years were examined. All patients underwent TEE in 2, 3 and 4-chamber positions before and after the surgery. The data were stored and analyzed on the EchoPAC (GE) workstation. Left ventricular ejection fraction (LVEF), end-diastolic (EDV) and end-systolic (ESV) volumes of the LV, as well as blood flow velocities in the aorta and LV with turbulence assessment were calculated. Quantitative parameters and structure of the blood flows in the LV and aorta were evaluated in the Multivox software based on the data of LV and valve apparatus anatomy. Intraventricular blood flows (V) and pressure gradients for one cardiac cycle were plotted.
RESULTS
The nature and subsequent calculations of the intraventricular and aortic blood flows are closely related to the valves and myocardial movement as well as the ascending aorta (AsAo) dimensions. High turbulence rates with uneven flow distribution in both the LV and aorta are noted in patients with dissecting aneurysms of AsAo in diastolic period before the surgery. Uneven intraventricular flow leads to additional increase in resistance and pressure gradient between the LV outflow tract and the aorta. Intra-aortic blood flow velocities are normalized and high turbulence almost disappears after the surgery. The gradient of blood flow velocity between the LV and aorta did not exceed 0.10±0.07 m/s on average during the ejection period.
CONCLUSION
TEE is a reliable and objective method for assessing the results of correction of the AsAo dissecting aneurysms. Normalization of intraventricular and intra-aortic blood flow velocities with turbulence relief is one of the criteria for surgery radicality. Recovery of tension and dynamics of direction of blood flow velocity vectors in the LV and aorta are important for determining the effectiveness of pathology correction.
