[The cardiac performance recovery pattern and central hemodynamics in patients with coronary heart disease during coronary bypass surgery under extracorporeal circulation].
Central hemodynamic parameters were retrospectively studied in 284 patients. After aortic declamping, sinus rhythm spontaneously restored in 179 patients (Group 1), ventricular fibrillation occurred in 105 (Group 2). The preoperative parameters were similar in both groups. The number of grafts and the time of aortic clamping and cardiopulmonary bypass (CPB) were higher in Group 1. In the groups, the volume of cardioplegic solution and the average dose of phenylephrine and nitroglycerin per perfusion did not differ. After CPB, the values of cardiac output (CO) and cardiac index (CI) were significantly higher in Group 1 than in Group 2. At the end of an operation and 3 hours after its termination, there were no differences between two groups. Twelve hours after surgery, cardiac output and systolic blood pressure were significantly higher in Group 1. Following 24 hours of surgery, heart rate was significantly greater in Group 1 than in Group 2 After surgery, all hemodynamic parameters were within normal physiological values. The mean duration and the degree of inotropic support did not differ in the groups. The incidence of atrial fibrillation, perioperative myocardial infarction, and low cardiac output syndrome were comparable in both groups. Thus, various modes of cardiac performance recovery affect perioperative hemodynamics; however, this impact is insignificant and does not make management policy be changed in such patients. After aortic declamping, ventricular fibrillation requiring for defibrillation is not a clinical sensitive factor that negatively affects the intra- and postoperative period.
Naumenko
K S
KS
Naumenko
S E
SE
Kim
S F
SF
Belavin
A S
AS
Pokrovskiĭ
M G
MG
Danilenko
A V
AV
Balabanov
I A
IA
Bravve
I Iu
IIu
D002407:Catheterization, Swan-Ganz; D001026:Coronary Artery Bypass / Q000379:methods*; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D005112:Extracorporeal Circulation; D006321:Heart / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies