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Nitroprusside and mitral stenosis

J G Stone, P F Hoar, A N Faltas

    Anesthesia and Analgesia
    |September 1, 1980
    PubMed
    Summary
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    Nitroprusside safely manages hypertension in mitral stenosis patients during surgery. It improves cardiac function, especially when severe pulmonary hypertension or mitral regurgitation is present.

    Area of Science:

    • Cardiovascular Medicine
    • Anesthesiology
    • Cardiac Surgery

    Background:

    • Patients with mitral stenosis often experience adverse hemodynamic changes during surgery.
    • Anesthesia and surgical stimulation can lead to hypertension and depressed cardiac function.

    Purpose of the Study:

    • To evaluate the cardiovascular effects of intravenous nitroprusside infusion in patients undergoing surgery for mitral stenosis.
    • To determine if nitroprusside improves hemodynamic parameters in this patient population.

    Main Methods:

    • Intraoperative evaluation of seven patients with pure mitral stenosis and seven with predominant mitral stenosis.
    • Administration of intravenous nitroprusside infusion.
    • Monitoring of systemic vascular resistance, arterial pressures, pulmonary pressures, cardiac index, and stroke volume.

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    Main Results:

    • Nitroprusside consistently reduced systemic vascular resistance and all measured pressures.
    • Cardiac index increased significantly in patients with predominant mitral stenosis (1.8 to 2.1 L/min/m2).
    • A near 50% increase in cardiac index and stroke volume was observed in individuals with severe pulmonary hypertension and/or mitral regurgitation.

    Conclusions:

    • Nitroprusside can be safely administered to control hypertension in mitral stenosis patients during surgery.
    • Nitroprusside improves cardiac function when severe pulmonary hypertension and/or mitral regurgitation coexist with mitral stenosis.