Biventricular function after myocardial revascularization in humans: deterioration and recovery patterns during the first 24 hours.

摘要: Critical changes in left and right ventricular function immediately after myocardial revascularization may affect the success of procedure, morbidity, mortality. To delineate these identify vulnerable patient populations times highest risk, was studied for 24 h 22 patients undergoing revascularization. Preoperative ejection fractions ranged from 0.26 to 0.81. For each patient, eight curves (LVFC RVFC) were generated by altering preload during 24-h perioperative period. Central venous pressure 0 19 mmHg pulmonary capillary wedge 31 mmHg. In all patients, significant (P less than 0.05) dysfunction occurred at 15 min following bypass, LVFCs RVFCs being depressed 35-75% control. The degree depression pattern recovery could be predicted best (stepwise logistic regression) two preoperative indices: fraction dyssynergy. Patients with greater 0.55 no dyssynergy (n = 11) had postbypass that 75% 60% control, respectively. However, depressions transient, 90% control within 4 contrast, having 0.45 or more severely 40% RVFC 30% control) persisted revascularization, resulting only function. conclusion, indices--ejection dyssynergy--best identified most likely have prolonged biventricular