[Monitoring myocardial performance after open heart surgery by calculation of diastolic and systolic pressure time index (author's transl)].
In order to determine the incidence of subendocardial ischemia after open heart surgery, subendocardial blood flow was monitored in 171 patients subjected to mitral and/or aortic valve replacement or coronary revascularization by on-line calculation of Diastolic (DPTI) and Systolic Pressure Time Index (TTI). Body hypothermia with an esophageal temperature of 25 degrees C and magnesium-aspartate-procaine cardioplegia were applied for myocardial protection. Ten patients developed low cardiac output state with two early deaths. In the two patients with fatal low cardiac output DPTI/TTI remained below 0.8. In the remaining 8 patients DPTI/TTI rose to 1.4 after a mean recovery time of 36 hours. In 161 patients (94%) no low cardiac output state evolved and DPTI/TTI rose to 1.3 within 60 min. after termination of cardiopulmonary bypass. Our results indicate that body hypothermia of 25 degrees C combined with magnesium-aspartate-procaine cardioplegia can reduce the incidence of subendocardial ischemia, but does not prevent this complication completely after anoxic times beyond 60-70 minutes.
D001794:Blood Pressure; D002302:Cardiac Output; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003327:Coronary Disease / Q000601:surgery; D006324:Heart Arrest, Induced / Q000379:methods*; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D008991:Monitoring, Physiologic; D011182:Postoperative Care; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000517:prevention & control
Uberwachung der Myokardfunktion nach offenen Herzoperationen durch Messung des diastolischen und systolischen Druck-Zeit-Index.