[Left ventricular dysfunctions after correction of aortic stenosis]

The purpose of the investigation was to study central hemodynamics and left ventricular function in low cardiac output after correction of aortic stenosis. The study included 34 patients (28 males and 6 females) aged 59. 7+/-1.5 years, surged with cardiopulmonary bypass (CPB). Low cardiac output was detected in all cases in the post-CPB period. Inotropic support with dopamine and/or dobutamine was effective in 47% of the patients (Group 1) and ineffective in 53% (Group 2). There were no statistically significant differences in cardiac index and pulmonary wedge pressure between the groups. Group 1 patients had ultrasound signs of left ventricular systolic dysfunction (low left ventricular ejection fraction and larger left ventricular systolic and diastolic areas in the transgastric position). Group 2 patients had ultrasound signs of left ventricular diastolic dysfunction (high left ventricular ejection fraction and smaller left ventricular systolic and diastolic areas). beta-blockers were used in 10 patients from Group 2. Central hemodynamics and left ventricular function normalized in all these cases. It is concluded that it is possible to recognize left ventricular dysfunctions in low cardiac output after aortic valve replacement with transesophageal echocardiography. Inotropic support is effective in only patients with left ventricular systolic dysfunction. Patients with left ventricular diastolic dysfunction should receive beta-blockers.