Systemic and pulmonary effects of nitroprusside during mitral valve replacement in patients with mitral regurgitation.

摘要: The effects of sodium nitroprusside on the systemic and pulmonary circulation were assessed in 17 patients with severe mitral regurgitation (MR) during valve replacement. In nine patients, MR was related to rheumatic heart disease, six resulted from acute myocardial infarction, two due subacute bacterial endocarditis. Nitroprusside administered intraoperatively at an infusion rate 10 65 mcg/min. During vasodilation therapy, forward stroke volume increased 34 +/- 2.8 46 4.8 ml, while left ventricular filling pressure decreased 28.7 1.9 20.6 < or = 1.8 mm Hg. There a significant decrease vascular resistance (from 2379 204 1646 161 dynes.sec.cm-5) mean arterial 89.8 4 78.1 5 Hg). Similarly, observed both 414 45 208 31 42.5 2.5 29.7 Hg) nitroprusside. all there magnitude peak V wave capillary wedge 45.2 3.9 26.1 3.1 These findings suggest that judicious intraoperative administration improves right function undergoing replacement, by increasing decreasing pressures (preload afterload).