Echocardiographic and Hemodynamic Evaluation of Cardiovascular Performance during Laparoscopy of Morbidly Obese Patients

Abstract

Background: The effects of morbid obesity, pneumoperitoneum (PP) and body position on cardiac function during laparoscopy were studied. Methods: Transesophageal echocardiography (TEE) was performed on 10 obese patients (body mass index, BMI, 48.1±1.8 kg/m2) and 10 normal weight patients (BMI = 22.6±0.8 kg/m2) in supine, Trendelenburg and reverse Trendelenburg positions before and after PP. Left ventricular end-systolic wall stress (LVESWS) was calculated from invasive blood pressure (BP) values and LV dimensions obtained by TEE. Diastolic filling was assessed by mitral valve and pulmonary vein flow velocities. Results: LVESWS was higher in obese patients both at baseline (46.0±4.0x103dyn/cm ..