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Changes in Systolic and Diastolic Ventricular Function with Cold Cardioplegic Arrest in Man
Author(s) -
Wallace Arthur,
Wai Lam Hon,
Nosé Peter S.,
Bellows Wayne,
Mangano Dennis T.
Publication year - 1994
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.1994.9.3s.497
Subject(s) - preload , medicine , cardiology , diastole , anesthesia , perioperative , stroke volume , blood pressure , hemodynamics , heart rate
Most of the cardiac surgery done today is performed with aortic cross‐clamping and cardlopiegic arrest. Despite improvements in cardloplegic techniques, ventricular dysfunction following cardlopiegic arrest is a major cause of perioperative morbidity and mortality. This experiment will quantify the changes in left ventricular systolic function with cold cardiopiegia. Four measures of cardiac function will be assessed with a volume conductance catheter. Methods and Results: Thirty patients undergoing coronary artery bypass graft surgery had volume conductance and micromanometer catheters placed in their left ventricles. Preload reduction was used to measure E es (the slope of the endsystolic pressure‐volume relationship), E dP/dtMax‐EDV (slope of dP/dtMax end‐diastolic volume relationship), EPLRSW (slope of stroke work end‐diastolic volume relationship), E ed (slope of the end‐diastolic pressure‐volume relationship), and ENegdP/dtMax‐EDV (slope of the negative dP/dtMax end‐diastolic volume relationship). E es decreased from 4.32 ± 2.94 prebypass to 2.52 ± 1.06 mmHg/mL postbypass. Conclusion: Cold cardiopiegic cardiac arrest is associated with postbypass systolic and diastolic ventricular dysfunction, which can be quantitated by volume conductance and micromanometer based measurements.