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Related Experiment Videos

Evaluation of left ventricular function in coronary bypass surgery.

K E Kjørstad1, T Myrmel

  • 1Institute of Clinical Medicine and Department of Thoracic and Cardiovascular Surgery, University Hospital of Tromsø, Norway. knutek@fagmed.uit.no

Scandinavian Cardiovascular Journal : SCJ
|February 24, 2001
PubMed
Summary

Preoperative ejection fraction (EF) predicts systolic function after heart surgery. End-systolic elastance (Ees) effectively detected post-surgery systolic stunning, but diastolic function assessment requires further development.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Assessing left ventricular (LV) systolic and diastolic function is crucial in cardiac surgery patients.
  • Non-invasive methods are preferred for perioperative monitoring.
  • Preoperative ejection fraction (EF) and end-diastolic pressure (EDP) are commonly used indicators.

Purpose of the Study:

  • To evaluate non-invasive indexes for measuring systolic and diastolic ventricular function.
  • To assess the predictive ability of preoperative EF and EDP for LV function post-coronary artery bypass grafting (CABG).

Main Methods:

  • End-systolic elastance (Ees) was measured perioperatively using transesophageal echocardiography and arterial pressure monitoring.
  • Diastolic function was assessed using three echocardiography/Doppler indexes.

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  • Caval balloon occlusions were used to induce preload variations for Ees assessment.

    • Main Results:

    • A significant positive correlation was observed between preoperative EF and perioperative Ees (r = 0.69, p = 0.03).
    • Ees significantly decreased after cardiopulmonary bypass (p < 0.001), indicating systolic stunning.
    • No significant correlations were found between preoperative EDP and non-invasive diastolic indexes.

    Conclusions:

    • Preoperative EF is a reliable predictor of intraoperative systolic function.
    • Semi-invasive Ees is a promising tool for monitoring LV systolic function and detecting perioperative stunning after bypass.
    • Current non-invasive diastolic function assessment methods require further refinement for perioperative use.