Changes in Systolic and Diastolic Ventricular Function with Cold Cardioplegic Arrest in Man

Publisher Website
Google Scholar
Abstract
Introduction: Most of the cardiac surgery done today is performed with aortic cross-clamping and cardlopiegic arrest. Despite improvements in cardloplegic techniques, ventricular dysfunction following cardlopiegic arrest is a major cause of perioperative morbidity and mortality. This experiment will quantify the changes in left ventricular systolic function with cold cardiopiegia. Four measures of cardiac function will be assessed with a volume conductance catheter. Methods and Results: Thirty patients undergoing coronary artery bypass graft surgery had volume conductance and micromanometer catheters placed in their left ventricles. Preload reduction was used to measure Ees(the slope of the endsystolic pressure-volume relationship), EdP/dtMax-EDV(slope of dP/dtMax end-diastolic volume relationship), EPLRSW (slope of stroke work end-diastolic volume relationship), Eed(slope of the end-diastolic pressure-volume relationship), and ENegdP/dtMax-EDV (slope of the negative dP/dtMax end-diastolic volume relationship). Eesdecreased from 4.32 ± 2.94 prebypass to 2.52 ± 1.06 mmHg/mL postbypass. Conclusion: Cold cardiopiegic cardiac arrest is associated with postbypass systolic and diastolic ventricular dysfunction, which can be quantitated by volume conductance and micromanometer based measurements.