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Alteration of ventricular function during coronary artery surgery
1Department of Anesthesiology, University of California, San Francisco.
Acta Chirurgica Scandinavica. Supplementum
|January 1, 1989
Summary
Coronary artery bypass surgery can cause significant left and right ventricular dysfunction. Preoperative ejection fraction and dyssynergy predict post-bypass recovery, with afterload reduction improving function.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Physiology
Background:
- Coronary artery bypass surgery (CABS) is a common procedure.
- Understanding post-operative cardiac function is crucial for patient outcomes.
Purpose of the Study:
- To investigate left and right ventricular (LV, RV) function changes during and after CABS.
- To identify predictors of ventricular dysfunction and recovery post-CABS.
Main Methods:
- Analysis of four studies involving 88 patients undergoing CABS.
- Utilized hemodynamic monitoring and radionuclide angiography.
- Categorized patients based on preoperative ejection fraction (EF) and ventricular dyssynergy.
Main Results:
- Two patient groups identified: Group I (EF > 0.50, no dyssynergy) and Group II (EF < 0.50 or dyssynergy).
- Group I showed preserved LV compliance and minimal depression in function post-CABS with rapid recovery.
- Group II exhibited decreased LV compliance, moderate to severe systolic dysfunction, and delayed recovery; afterload reduction improved function more significantly in this group.
Conclusions:
- Significant systolic and diastolic ventricular dysfunction occurs post-CABS.
- Preoperative EF and dyssynergy predict the extent of dysfunction and recovery time.
- Afterload reduction is beneficial, while preload augmentation is ineffective when wedge pressure is elevated.