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  • Title: [Effects of tourniquet on cardiac function in total knee arthroplasty with trans-esophageal echocardiography].
    Author: Feng L, Zhang XG, Yang QG, Wang G.
    Journal: Zhonghua Yi Xue Za Zhi; 2013 Dec 17; 93(47):3755-7. PubMed ID: 24548391.
    Abstract:
    OBJECTIVE: To employ trans-esophageal echocardiography (TEE) to observe the tourniquet's influence on cardiac function in total knee arthroplasty (TKA). METHODS: Twenty ASA I-II patients undergoing TKA under general anesthesia from September 2011 to February 2012 at Department of Orthopedics, Beijing Jishuitan Hospital were selected. Tourniquet was loosened at 30 minutes after the start of TKA. And TEE was employed to observe the occurrence rate and degree of intra-cardiac embolus and the changes of cardiac function at 5, 10 and 15 min post-loosening respectively. RESULTS: Different degrees of "meteor-shaped" microemboli images appeared in right atriums of all patients. The "meteor shape" image was the most obvious after loosening for 5 min. It started to decrease after 10 min, persisted generally and declined further after 15 min. The left ventricular areas at end diastole (LVAd) after loosening tourniquet for 5, 10 and 15 min were (7.62 ± 0.54), (7.86 ± 0.46) and (8.55 ± 0.56) cm(2) respectively. And there were remarkable changes compared with the area (9.80 ± 0.48) cm(2) pre-loosening (P < 0.01). The fractional area change (FAC) showed obvious decrease since loosening for 5 min (P < 0.01). CONCLUSION: Massive meteor-shaped microembolis appear on TEE with weakened cardiac function.
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