[The importance of hemodynamic monitoring in mitral and tricuspid valve surgery].
BACKGROUND
Untreated mitral valve disease is associated with marked hemodynamic disorders, low ejection fraction (EF) and poor perfusion. The study aimed to explore the importance of hemodynamic monitoring in intraoperative evaluation and treatment of these patients.


METHODS
This prospective study included 85 patients: group 1: 41 patients, EF<40%; group 11: 44 patients, EF>40%. Hemodynamic parameters were recorded after initation of anesthesia (1), after sternotomy (2), after extracorporeal circulation (ECC) (3) and before leaving the operation theatre (4). The following parameters were assessed: mean arterial pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance index, central venous pressure, cardiac index. Statistical analysis was performed using Student t-test and correlation analyses in time series.


CONCLUSIONS
Hemodynamic parameters were changed at the beginnig of surgery, but gradually improved after sternotomy and were normal at the end of the operation. Both examined groups presented with reduction of the pulmonary artery preassure, pulmonary capillary wedge pressure, pulmonary vascular resistance index (reduction more than 30%) and cardiac index (up to 100%). Strong correlation between 1/2 and 3/4 assessments pointed to the importance of intraoperative evaluation. Swan-Ganz catheter ia a valuable tool used for hemodynamic monitoring.


CONCLUSIONS
Intraoperative medication (based on obtained hemodynamic parameters) and operative treatment led to normalization of all parameters in both groups, regardless of the preoperative values of EF.
Dobrić
Biljana J
BJ
Medicinski fakultet, Novi Sad, Institut za kardiovaskularne bolesti.
Petrović
Jasna S
JS
Radovanović
Ninoslav D
ND
D002320:Cardiovascular Physiological Phenomena; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D016343:Monitoring, Intraoperative; D013318:Stroke Volume; D014261:Tricuspid Valve / Q000601:surgery*