Journal Article

The incidence and haemodynamic significance of gas emboli during operative hysteroscopy: a prospective echocardiographic study

David Leibowitz, Neta Benshalom, Yevgeny Kaganov, David Rott, Arie Hurwitz and Yaron Hamani

in European Heart Journal - Cardiovascular Imaging

Published on behalf of European Society of Cardiology

Volume 11, issue 5, pages 429-431
Published in print June 2010 | ISSN: 2047-2404
Published online January 2010 | e-ISSN: 2047-2412 | DOI: http://dx.doi.org/10.1093/ejechocard/jep232
The incidence and haemodynamic significance of gas emboli during operative hysteroscopy: a prospective echocardiographic study

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Aims

Operative hysteroscopy is associated with complications including the development of gas embolism. The aim of this study was to utilize continuous echocardiographic imaging during operative hysteroscopy to assess the extent and the haemodynamic effects of gas embolism in these patients.

Methods and results

Women undergoing operative hysteroscopy under general anaesthesia without a history of cardiac disease were eligible. Transthoracic echocardiography (TTE) was performed continuously in all study participants with assessment of the extent and frequency of gas embolism, right ventricular function and pulmonary hypertension. Twenty-three women (mean age: 48.0 ± 9.4 years) participated in the study. All subjects had evidence of bubble embolism in the right atrium (RA) and 20 of 23 (85%) had evidence of continuous flow of bubbles. In the 17 patients with adequate assessment, estimated pulmonary artery systolic pressure was 19.1 ± 3.7 mmHg prior to the procedure and 23.3 ± 3.4 following the procedure, a statistically significant difference (P < 0.05). There were no significant changes between the two groups in right ventricular end-diastolic area, end-systolic area, or fractional area change.

Conclusion

Our study demonstrates a high frequency of continuous gas embolism during hysteroscopy, which is associated with a small but statistically significant increase in pulmonary artery systolic pressure without affecting right ventricular function.

Keywords: Echocardiography; Gas embolism; Pulmonary hypertension

Journal Article.  1579 words.  Illustrated.

Subjects: Cardiovascular Medicine

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