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Left ventricular function during aortic surgery

R M Carroll, R B Laravuso, J F Schauble

    Archives of Surgery (Chicago, Ill. : 1960)
    |July 1, 1976
    PubMed
    Summary
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    Abdominal aortic surgery can cause myocardial ischemia. Propranolol hydrochloride and sodium nitroprusside effectively treated this condition in patients experiencing cardiac events during surgery.

    Area of Science:

    • Cardiovascular Surgery
    • Anesthesiology
    • Cardiology

    Background:

    • Abdominal aortic surgery poses risks for patients with pre-existing cardiovascular conditions like hypertension and myocardial infarction.
    • Patients undergoing these procedures may have comorbidities such as chronic obstructive pulmonary disease.

    Purpose of the Study:

    • To investigate the occurrence of myocardial ischemia during abdominal aortic surgery.
    • To evaluate the effectiveness of specific pharmacological interventions for managing intraoperative myocardial ischemia.

    Main Methods:

    • Study involved fourteen patients undergoing abdominal aortic surgery.
    • Monitoring included electrocardiography and pulmonary artery occluded (PAo) pressure measurements.
    • Treatment involved propranolol hydrochloride and sodium nitroprusside.

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    Main Results:

    • Two patients experienced tachycardia, hypertension, and elevated PAo pressure during laryngoscopy and intubation.
    • Two patients showed elevated PAo pressure during aortic cross-clamping.
    • Three of these four patients developed electrocardiographic evidence of myocardial ischemia.

    Conclusions:

    • Intraoperative hemodynamic changes during abdominal aortic surgery can precipitate myocardial ischemia.
    • Propranolol hydrochloride and sodium nitroprusside are effective in managing myocardial ischemia in this surgical context.