[Effect of myocardial preservation and preoperative left ventricular end-diastolic pressure upon the early postsurgical cardiac function after prosthetic cardiac valve replacement].
We investigated the effect of myocardial preservation and preoperative stroke work index (SWI) and left ventricular end-diastolic pressure (LVEDP) upon the early postsurgical kinetics of left ventricular function in thirty-four patients after prosthetic cardiac valve replacement. They received both-sided cardiac catheterization and measurement of cardiac output by dye dilution method in a standard fashion. Myocardial temperature was measured simultaneously and consecutively during aortic cross-clamping period (greater than 70 min) on open heart surgery. Thereafter, each postsurgical left ventricular function was estimated at three, six, twenty-four and forty-eight hours after weaning from cadiopulmonary bypass (CPB) by using Swan-Ganz catheter. SWI0 X 1000/AnI was used as an improved index of postsurgical cardiac function, because it was incorporated with the preoperative left ventricular stroke work index (SWI0) and anoxic index (AnI), which was the integral of myocardial temperature during aortic cross-clamping period. Otherwise, we regarded LVEDP as an estimate of preoperative cardiac function. So we compared them with the early postsurgical left ventricular SWI, respectively. As a result, the relation between SWI0 and the postsurgical SWI (SWI24 and SWI48) showed positive correlations with correlation coefficients 0.52 and 0.70, and the relation between AnI and the early postsurgical SWI (SWI3 and SWI6) showed negative correlations with correlation coefficients -0.56 and -0.52. While the relation between SWI0 X 1000/AnI and postsurgical SWI (from SWI0 to SWI48) showed positive correlations with correlation coefficients decreasing from 0.76 to 0.57. LVEDP showed negative correlations to SWI0 and SWI48 with correlation coefficients -0.48 and -0.45.(ABSTRACT TRUNCATED AT 250 WORDS)
Kuraoka
S
S
Kobayashi
M
M
Orita
H
H
Shimanuki
T
T
Abe
H
H
Kohno
M
M
Inue
K
K
Fukasawa
M
M
Washio
M
M
D000328:Adult; D001794:Blood Pressure; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006324:Heart Arrest, Induced; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D013318:Stroke Volume