The dicrotic pulse: a common, non-ominous finding after the Ross operation

Area of Science:

• Cardiology
• Vascular Surgery
• Cardiac Surgery

Background:

• A dicrotic pulse, an unusual arterial waveform, has been associated with low cardiac output and poor prognosis.
• Its occurrence after a Ross operation requires further investigation.

Purpose of the Study:

• To investigate the incidence and significance of dicrotic pulses post-Ross operation.
• To determine the correlation between preoperative aortic insufficiency and the development of a dicrotic pulse.

Main Methods:

• Retrospective review of 33 patients undergoing Ross procedure (2000-2004).
• Analysis of preoperative echocardiograms and postoperative radial arterial pressure tracings.
• Comparison of dicrotic pulse incidence based on preoperative aortic insufficiency severity.

Main Results:

• A dicrotic pulse was observed in 61% (20/33) of patients post-Ross operation.
• Moderate to severe preoperative aortic insufficiency was significantly associated with dicrotic pulse occurrence (95% vs 23%, p<0.001).
• No association found between dicrotic pulse and increased vasoactive infusions or hospitalization duration.

Conclusions:

• The dicrotic pulse is a frequent postoperative finding in Ross procedure patients.
• It is strongly linked to preoperative aortic insufficiency and does not signify a poor outcome.
• Potential mechanisms may involve altered vascular compliance due to chronic aortic insufficiency.