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Ann Thorac Surg 1984;38:117-123
© 1984 The Society of Thoracic Surgeons

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Articles

Sonomicrometry: Its Application as a Routine Monitoring Technique in Cardiac Surgery

Departments of Cardiology and Cardiothoracic Surgery and the Research Service, Veterans Administration Medical Center, San Diego, CA

Accepted for publication February 20, 1984.

^* Address reprint requests to Dr. Moores, Department of Surgery, VA Medical Center (112J), 3350 La Jolla Village Dr, San Diego, CA 92161

We utilized ultrasonic-dimension crystals in approximately 50 patients during a three-year period to evaluate clinical sonomicrometry as a routine monitoring tool in patients undergoing cardiac operations. Standard research piezoelectric pulse transit ultrasonic transducers were modified with a hooked attachment in a tethered configuration to facilitate accurate alignment and quick insertion for the measurement of myocardial segment length changes. These segment crystals were used both intra-operatively and postoperatively to evaluate the left ventricular pressure–geometry relationships and to serve as a continuous monitor of myocardial function. The left ventricular pressure–volume relationship was varied by temporarily reapproximating the pericardium (pericardial closure resulted in a 12% reduction in fractional shortening, a 5% decrease in end-diastolic segment length, and an 8% increase in pulmonary artery diastolic pressure). During both the intraoperative and postoperative periods, we found good correlation between thermodilution, stroke volume, and myocardial dimensions; no correlation was noted between pulmonary artery diastolic pressure and stroke volume. No bleeding or major complications resulted from the use of these sonomicrometry transducers. Our initial clinical experience with sonomicrometry seems to support its use as a potentially valuable monitoring tool.

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