Depression and recovery of right ventricular function after cardiopulmonary bypass

Stein, Keith L.; Breisblatt, Warren M.; Wolfe, Cynthia J.; Gasior, Thomas A.; Hardesty, Robert L.

doi:10.1097/00003246-199011000-00001

Cited by 53 publications

(18 citation statements)

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“…No improvement was seen during the follow-up period. Impaired RV function is a known effect of cardiac surgery [13,14]. In our two groups of ischemic and non-ischemic dilated CM patients, we detected similar preoperative LV and RV function and no group differences in postoperative RV dysfunction were observed.…”

Section: Discussionsupporting

confidence: 63%

Echocardiographic findings using tissue velocity imaging following passive containment surgery with the Acorn CorCap™ cardiac support device

Olsson

Bredin

Franco‐Cereceda

2005

European Journal of Cardio-Thoracic Surgery

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Section: Discussionsupporting

confidence: 63%

Echocardiographic findings using tissue velocity imaging following passive containment surgery with the Acorn CorCap™ cardiac support device

Olsson

Bredin

Franco‐Cereceda

2005

European Journal of Cardio-Thoracic Surgery

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“…MPAIRED right ventricular (RV) function due to elevated pulmonary vascular resistance (PVR) can make discontinuation of cardiopulmonary bypass (CPB) particularly laborious and urgent reinitiation of CPB is sometimes deemed necessary. 1 Research in recent years has been directed towards inhaled routes for the treatment of pulmonary hypertension (PH) as well as the introduction of new techniques to optimize drug delivery. The importance of pursuing the inhaled route for the treatment of PH lies in its selectivity for the lung as well as a decrease in the risk of systemic drug effects.…”

mentioning

confidence: 99%

Inhaled iloprost controls pulmonary hypertension after cardiopulmonary bypass

Theodoraki

Rellia

Thanopoulos

et al. 2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Severe pulmonary hypertension (PH) is a major cause of right ventricular (RV) dysfunction. Various iv vasodilator modalities have been used with limited results because of lack of pulmonary selectivity. The aim of the present controlled study was to evaluate the efficacy of inhaled iloprost, a synthetic prostacyclin analogue, in patients with elevated pulmonary vascular resistance (PVR) immediately after separation from cardiopulmonary bypass (CPB).M Me et th ho od ds s: : Twelve patients with persistent PH after discontinuation of CPB were included in the study. In all patients standard hemodynamic monitoring was used. Inhaled iloprost was administered via nebulized aerosol at a cumulative dose of 0.2 µg·kg -1 for a total duration of 20 min. Complete sets of hemodynamic measurements were performed before inhalation (baseline), during and after cessation of the inhalation period. Echocardiographic monitoring of RV function was also used.R Re es su ul lt ts s: : Inhaled iloprost induced a reduction in the transpulmonary gradient at the end of the inhalation period in comparison to baseline (9.33 ± 3.83 mmHg vs 17.09 ± 6.41 mmHg, P < 0.05). The mean pulmonary artery pressure to systemic artery pressure ratio decreased over this period (0.28 ± 0.08 vs 0.45 ± 0.17, P < 0.05). A statistically significant decrease of the PVR to systemic vascular resistance ratio was also observed (0.15 ± 0.05 vs 0.21 ± 0.05, P < 0.05). Improved indices of RV function were observed in echocardiographic monitoring.C Co on nc cl lu us si io on n: : Inhaled iloprost appears to be a selective pulmonary vasodilator and may be effective in the initial treatment of PH and the improvement of RV performance in the perioperative setting. (9,33 ± 3,83 mmHg vs 17,09 ± 6,41 mmHg, P < 0,05). Le ratio de la pression artérielle pulmonaire moyenne sur la pression artérielle systémique a diminué pendant cette période (0,28 ± 0,08 vs 0,45 ± 0,17, P < 0,05). Une baisse statistiquement significative du ratio de la RVP sur la résistance vasculaire générale a été aussi observée (0,15 ± 0,05 vs 0,21 ± 0,05, P < 0,05 Objectif : L'hypertension pulmonaire sévère (HP) est une cause majeure de dysfonction du ventricule droit (VD). Diverses modalités vasodilatatrices iv ont été utilisées et ont donné des résultats limités, étant donné le manque de sélectivité pulmonaire. Notre but était d'é-valuer l'efficacité de l'inhalation d'iloprost, un analogue de la prostacycline synthétique, chez des patients qui présentent une résistance vasculaire pulmonaire (RVP) élevée immédiatement après le sevrage de la circulation extracorporelle (CEC). Méthode : Douze patients présentant une HP persistante après l'interruption de la CEC ont été inclus dans l'étude. Une surveillance standard des paramètres hémodynamiques a été utilisée pour tous les patients. L'administration d'iloprost a été faite à l'aide d'un nébuliseur Résultats : L'iloprost inhalé a provoqué une réduction du gradient transpulmonaire à la fin de l'inhalation, en comparaison avec les m...

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“…11,12 The negative effects of cardiopulmonary bypass on RV function have been widely reported; 13-15 however, Stein et al reported a recovery of RV function after initial depression due to cardiopulmonary bypass within 24 hours. 16 In our patient population, all patients showed a significant decline in tissue Doppler systolic and diastolic velocities from the preoperative to the postoperative period, quantitatively indicating that clinical postoperative recovery occurs despite severe decrease in systolic and diastolic function. One may speculate that placement of an RV to a PA conduit requiring an RV incision may have a role in decreasing postoperative indices.…”

Section: Discussionmentioning

confidence: 59%

Pre‐ and Postoperative Quantitation of Right Ventricular Tissue Doppler Velocities in Infants with Hypoplastic Left Heart Syndrome

et al. 2006

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These data indicate that following the institution of PGE and initial medical and ventilatory management, there is an increase in RV annular and septal systolic velocities from the initial to the preoperative period and that these indices as well as RV annular diastolic velocities decline significantly postoperatively. Initial septal diastolic velocities were severely abnormal and did not significantly change pre- and postoperatively. These data may have significance for both postoperative and subsequent long-term RV function.

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Depression and recovery of right ventricular function after cardiopulmonary bypass

Cited by 53 publications

References 0 publications

Echocardiographic findings using tissue velocity imaging following passive containment surgery with the Acorn CorCap™ cardiac support device

Echocardiographic findings using tissue velocity imaging following passive containment surgery with the Acorn CorCap™ cardiac support device

Inhaled iloprost controls pulmonary hypertension after cardiopulmonary bypass

Pre‐ and Postoperative Quantitation of Right Ventricular Tissue Doppler Velocities in Infants with Hypoplastic Left Heart Syndrome

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