The Effect of Preoperative Pulmonary Arterial Pressure and Right Ventricular Function on the Changes in Right Ventricular Function after Mitral Valve Replacement.
10.4097/kjae.2001.40.1.16
- Author:
Sang Hwa KANG
1
;
Young Lan KWAK
;
Yon Hee SHIM
;
Young Jun OH
;
Sang Boem NAM
;
Jun Hee PARK
;
Yong Woo HONG
Author Information
1. Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Blood pressure, hypertension: pulmonary;
Heart: hemodynamics;
right ventricular ejection fraction;
Surgery: mitral valve replacement
- MeSH:
Arterial Pressure*;
Cardiopulmonary Bypass;
Catheters;
Hemodynamics;
Humans;
Hypertension, Pulmonary;
Mitral Valve*;
Postoperative Period;
Pulmonary Artery;
Stroke Volume;
Vascular Resistance;
Ventricular Function, Right*
- From:Korean Journal of Anesthesiology
2001;40(1):16-21
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In patients with mitral valvular disease with pulmonary hypertension (PHT) accompanying right ventricular (RV) dysfunction, mitral valve replacement (MVR) improves RV function and other hemodynamic variables in long term follow-up. However, there are controversies in improvement of RV function in the immediate postoperative period. We compared the RV function immediately after a MVR with a pulmonary artery catheter (PAC) between patients with normal and decreased RV function with PHT preoperatively. METHODS: Twenty nine patients undergoing a MVR were included in the study. The patients (n = 14) with mean pulmonary arterial pressure (PAP) < or = 25 mmHg were assigned to group I and the patients (n = 15) with mean PAP 25 mmHg were assigned to group II. A PAC with rapid response-thermistors which enables us to determine right ventricular ejection fraction (RVEF) was inserted in all patients and hemodynamic variables were measured before and after cardiopulmonary bypass (CPB). RESULTS: After CPB, PAP, pulmonary vascular resistance index (PVRI), and RV end-diastolc volume (RVEDV) were significantly decreased and RVEF was significantly increased in group II compared with group I in which no hemodynamic variables were changed. CONCLUSIONS: A MVR decreased RV afterload and increased RV function more significantly in patients with preoperative PHT accompanying RV dysfunction than in patients with normal PAP preoperatively.
