[Intraoperative diagnosis of the heart and great vessels--measuring blood pressure].
The measurement and registration of pressures and pressure tracings in the cavities of the heart and the great vessels by means of direct punction during cardiac operation follows the same methods as in the catheter-laboratory. The pressure-curves should also be displayed on satellite-screens in sight of the operating surgeon, the anesthetist, and the pump-technician, together with the intraoperatively most important ECG-leads. In our opinion, four pressure-lines for simultaneous registration are necessary. The patient control requires two systems (arterial or aortic pressure, central-venous or left atrial pressure) for the estimation of global myocardial function, conduct of anesthesia and drug therapy, volume-steering, and for the control of the extracorporeal circulation. The intraoperative control or completion of the diagnostic criteria of the underlying cardiac lesion demands at least two additional pressure lines, that also serve for quality control after the corrective procedure. Transitory alteration caused by a particular operative situation can be differentiated from a lesion needing surgical intervention by making use of such functional tests as volume variation, pharmacological provocation, pacemakerstimulation, etc. The careful interpretation of intraoperatively derived pressure-tracings seems to be a useful and unavoidable surgical method in the cardiac operating room that can be easily realized without any harm to the patient, and with reliable results and with low costs.
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Chirurgische Klinik und Poliklinik, Heinrich-Heine-Universität, Abteilung für Thorax- und Kardiovaskularchirurgie, Düsseldorf.
D001794:Blood Pressure / Q000502:physiology; D015924:Blood Pressure Monitors; D006331:Heart Diseases / Q000601:surgery*; D006349:Heart Valve Diseases / Q000601:surgery; D006351:Heart Valves / Q000503:physiopathology; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000503:physiopathology
Intraoperative Diagnostik des Herzens und der herznahen grossen Gefässe--Druckmessung.