• Kiichi Yano, Yuki Toyama, Takafumi Iida, Kentaro Hayashi, Keiya Takahashi, and Hirotsugu Kanda.
• Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, Japan. Electronic address: yanoki39@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2021 Jun 1; 35 (6): 1663-1669.

ObjectiveThis study aimed to compare measurements of right ventricular function using three-dimensional transesophageal echocardiography (3D TEE), and pulmonary artery catheters (PACs) in patients undergoing cardiac surgery. The authors examined the practicality of using the 3D TEE.DesignProspective observational.SettingCardiac operating room at a single university hospital.ParticipantsAll adult patients undergoing elective cardiac surgery at a single tertiary care university hospital over two years.InterventionsNone.Measurements And Main ResultsRight ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), stroke volume (SV), and right ventricular ejection fraction (RVEF) were measured with both 3D TEE and PACs. Assessments were performed using correlation coefficients, paired t tests, and Bland-Altman plots. Thirty-one patients participated in this study. Each measurement showed good agreement. RVEDV and RVESV were slightly lower on 3D TEE than on PAC (205.9 mL v 220.2 mL, p = 0.0018; 143.0 mL v 155.5 mL, p = 0.0143, respectively), whereas no significant differences were observed for SV and RVEF (31.0% v 31.1%, p = 0.0569; 61.6 mL v 66.9 mL, p = 0.92, respectively). Linear regression analysis showed high correlation between 3D TEE and PAC for RVEDV (r = 0.87) and RVESV (r = 0.81), and moderate correlation for SV (r = 0.67) and RVEF (r = 0.67). In the Bland-Altman plot, most patients were within the 95% limits of the agreement throughout all measurements.ConclusionA high correlation was found between measurements made with a PAC and with 3D TEE in the assessment of right ventricular function. Three-dimensional TEE would be a potential alternative to PAC for assessment of right ventricular function during intraoperative periods.Copyright © 2020 Elsevier Inc. All rights reserved.

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