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Transient hemodynamic dysfunction after myocardial revascularization. Temperature dependence.

L Czer, A Hamer, F Murphy

    The Journal of Thoracic and Cardiovascular Surgery
    |August 1, 1983
    PubMed
    Summary

    Transient hemodynamic dysfunction occurs during rewarming after heart surgery. This dysfunction is temperature-dependent and not improved by right atrial pacing, highlighting the importance of temperature monitoring in patient recovery.

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    Area of Science:

    • Cardiovascular Surgery
    • Cardiac Anesthesia
    • Hemodynamics

    Background:

    • Myocardial revascularization often involves hypothermic cardioplegia.
    • Postoperative hemodynamic assessment is crucial for patient recovery.

    Purpose of the Study:

    • To investigate hemodynamic changes during rewarming after myocardial revascularization.
    • To evaluate the efficacy of right atrial pacing in improving hemodynamics during rewarming.

    Main Methods:

    • Studied 12 patients with normal preoperative left ventricular ejection fraction (LVEF) undergoing myocardial revascularization.
    • Measured hemodynamics at various temperatures during rewarming (90-98°F) and 24 hours postoperatively.
    • Assessed the effects of right atrial pacing (110 bpm) on hemodynamic parameters.

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    Main Results:

    • Significant decreases in cardiac index, stroke volume index, and left ventricular stroke work index (LVSW) were observed at 90°F.
    • Hemodynamic dysfunction during rewarming was temperature-dependent, with inverse correlation between cardiac index and systemic vascular resistance index (SVRI).
    • Right atrial pacing did not improve hemodynamic function during the rewarming period.

    Conclusions:

    • Transient hemodynamic dysfunction occurs during rewarming after myocardial revascularization.
    • This dysfunction is directly related to temperature.
    • Right atrial pacing does not mitigate hemodynamic impairment during the rewarming phase; temperature management is critical.