Intraoperative assessment of acute hemodynamic changes after partial left ventriculectomy.
Partial left ventriculectomy (PLV) has been introduced as an alternative surgical therapy for patients with end-stage dilated cardiomyopathy. The physiological benefits of PLV are relatively unknown. Therefore, the objective of this study was to determine the acute effects of PLV by measuring cardiac function before and after PLV. Aortic and left ventricular pressures and aortic flow were measured in eight patients. Continuous, beat-to-beat data were recorded and compared pre-PLV and post-PLV with and without inferior vena cava (IVC) occlusions. PLV increased cardiac output (0.93+/-0.5, p = 0.01) as a result of increased stroke volume (5.12+/-4.24, p = 0.06) and heart rate (14.5+/-8.44, p = 0.02). Contractility (+/- dP/dt, 240.33+/-74.28, p = 0.001) and external work (650.8+/-320.4, p = 0.01) were also improved. Left ventricular end-diastolic elastance (0.15+/-0.14, p = 0.10) nearly doubled after PLV. Our results indicated an improved cardiac function as measured by increased cardiac output, stroke volume, ejection fraction (EF), and contractility.
Koenig
S
S
Jewish Hospital Heart and Lung Institute, The Department of Surgery, University of Louisville, Kentucky 40202, USA. sckoen01@athena.louisville.edu
Shafie
M
M
Pearson
A
A
Laureano
M A
MA
Cerrito
P
P
Ewert
D
D
Schroeder
M
M
Dowling
R D
RD
D002302:Cardiac Output; D006348:Cardiac Surgical Procedures; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology* / Q000601:surgery*; D006339:Heart Rate; D006352:Heart Ventricles / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D007432:Intraoperative Period; D011184:Postoperative Period; D013318:Stroke Volume