Transesophageal echocardiography to assess mitral valve function and flow during cardiopulmonary resuscitation

Thomas R. Porter, Joseph P. Ornato, Cathy S. Guard, Valerie G. Roy, Carolyn A. Burns, J. V. Nixon

Research output: Contribution to journalArticle

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Abstract

This study further defines the mechanism of blood flow during closed-chest compression using transesophageal Doppler echocardiography. Although the echocardiographic demonstration of mitral valve closure during closed-chest compression has been used as evidence of direct cardiac compression, mitral valve closure has also been documented to occur during resuscitation by selectively increasing intrathoracic pressure. Transesophageal Doppler echocardiography was used to assess mitral valve position and flow in 17 adult patients undergoing cardiopulmonary resuscitation with a mechanical piston compression device. Left and right ventricular fractional shortening, mitral valve position with chest compression, timing and magnitude of transmitral flow, and anteroposterior chest diameter were recorded. In 12 patients (group I), the mitral valve closed during the downstroke of chest compression; in the remaining 5 (group II), it opened further. Peak transmitral flow occurred during the release phase and was significantly higher (p < 0.05) in group I (39.5 ± 9.3 cm/s) than the peak flow in group II (21.3 ± 5.9 cm/s), which occurred during the downstroke of chest compression. Left ventricular fractional shortening inversely correlated (r = -0.68; p = 0.02) with the anteroposterior chest diameter, but did not correlate with peak transmitral flow (r = 0.34; p = not significant). It is concluded that the mitral valve closes during the downstroke of chest compression in most adult patients during resuscitation. The absence of a relation between mitral valve flow and left ventricular fractional shortening supports the hypothesis that other factors such as nonuniform increases in intrathoracic pressure cause the mitral valve to open or close during chest compression.

Original languageEnglish (US)
Pages (from-to)1056-1060
Number of pages5
JournalThe American Journal of Cardiology
Volume70
Issue number11
DOIs
StatePublished - Oct 15 1992

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Transesophageal Echocardiography
Cardiopulmonary Resuscitation
Mitral Valve
Thorax
Doppler Echocardiography
Resuscitation
Pressure
Equipment and Supplies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Transesophageal echocardiography to assess mitral valve function and flow during cardiopulmonary resuscitation. / Porter, Thomas R.; Ornato, Joseph P.; Guard, Cathy S.; Roy, Valerie G.; Burns, Carolyn A.; Nixon, J. V.

In: The American Journal of Cardiology, Vol. 70, No. 11, 15.10.1992, p. 1056-1060.

Research output: Contribution to journalArticle

Porter, Thomas R. ; Ornato, Joseph P. ; Guard, Cathy S. ; Roy, Valerie G. ; Burns, Carolyn A. ; Nixon, J. V. / Transesophageal echocardiography to assess mitral valve function and flow during cardiopulmonary resuscitation. In: The American Journal of Cardiology. 1992 ; Vol. 70, No. 11. pp. 1056-1060.
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