PMID: 11903070Mar 21, 2002Paper

Reducing the risk of systemic embolization during gynecologic laparoscopy--effect of volume preload

Acta Anaesthesiologica Scandinavica
T TuppurainenM Salonen

Abstract

About 27% of the population is known to have a patent foramen ovale. It can be opened if the left atrial pressure is less than the right atrial pressure. This pressure reversal has been reported during gynecologic laparoscopic surgery. The present paper describes with help of transesophageal echocardiography the pressure relationship between the atria during laparoscopic surgery and the effect of volume preload. Twenty-one gynecologic ASA 1-3 patients were included in this open study. The movement of interatrial septum was monitored with transesophageal echocardiography during the procedure. If the septum movement was to the left, the patient was given 500 mL hydroxyethyl starch to increase the filling pressures. After induction, the mobile part of foramen ovale rounded to the right in 15 patients but six patients showed movement to the left. After pneumoperitoneum and head-down tilt, one patient of the six returned to normal but eight additional patients showed movement to the left. These 13 patients had a filling infusion of 500 mL hydroxyethyl starch. The movement was normalized in 12 patients. We saw echogenic particles coming from the inferior caval vein in every patient. Only one patient had very small atrial septal defec...Continue Reading

References

Feb 1, 1996·Acta Anaesthesiologica Scandinavica·P GannedahlA Sollevi
Aug 12, 1998·Acta Anaesthesiologica Scandinavica·T HachenbergM Wendt
Mar 14, 2000·Acta Anaesthesiologica Scandinavica·J P TournadreD Chassard

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Citations

Jul 21, 2011·Journal of Anaesthesiology, Clinical Pharmacology·Amir Abu ZikryKhaled H Alanezi
Jul 6, 2014·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Magnus C Johansson, Cecilia Wallentin Guron

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