IMPROVED DETECTION OF PERIOPERATIVE MYOCARDIAL-ISCHEMIA WITH MULTIPLANE (HEWLETT-PACKARD) TRANSESOPHAGEAL SCANNING - 2-DIMENSIONAL BIPLANE AND TRANSMITRAL DOPPLER-ECHOCARDIOGRAPHY

The transesophageal multiplane (omniplane) probe (Hewlett Packard) wit h a rotable cross-section scanning plane was used to assess perioperat ive: myocardial ischemia. By not moving the probe, the process of moni toring is simplified, and the introduction of false-positive results s econdary to changes in orientation of the transducer is minimized, Inc orporating biplane imaging, the multiplane device constitutes the logi cal step in imaging options, extracting maximal information from two-d imensional and Doppler echocardiography in detecting myocardial ischem ia. The additional use of the left ventricular long axis view enhances the possibilities of two-dimensional echocardiography for detecting m yocardial ischemia because it permits the apex as well as the base of the ventricle to be visualized, Pulsed Doppler transmitral inflow para meters for myocardial ischemia represent an excellent opportunity for the detection of ischemia in cases when two-dimensional echocardiograp hy cannot be applied (i.e., nonischemic causes of abnormal wall motion pattern: bundle branch block, ventricular pacing, prosthetic valves, stunned myocardium, and unmasking of areas of scarring by changes in a fterload, We therefore concluded that transesophageal imaging with an omniplane probe provides three types of evaluation of perioperative my ocardial ischemia that supplement each other and improve the method.