Treatment of perioperative low cardiac output syndrome

Doyle, Anthony R.; Dhir, Achal; Moors, A.H.; Latimer, R.D.

doi:10.1016/0003-4975(94)00916-u

Cited by 32 publications

(13 citation statements)

References 16 publications

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“…[2] Myocardial stunning, anesthetic agents, vasodilation and hyperthermia caused by the inflammatory response associated with CPB, all contributes to hemodyanamic instability in the early post-operative period. [6] The recovery from this phenomenon starts after one hour of termination of CPB, and continues till 24 hours post-CPB.…”

Section: Discussionmentioning

confidence: 99%

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A comparison of hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve repair / replacement for severe mitral stenosis

et al. 2013

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Section: Discussionmentioning

confidence: 99%

“…[1,2] Patients of critical mitral valve stenosis are known to present with low cardiac output following mitral valve surgery. Positive inotropic drugs and vasodilators are administered to treat this condition.…”

Section: Introductionmentioning

confidence: 99%

A comparison of hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve repair / replacement for severe mitral stenosis

et al. 2013

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“…The protection of the right side of the heart has been claimed to be crucial to myocardial preservation [4]. This is supported by experimental data which showed that chemiluminescence values in rabbit hearts were higher in the right than in the left ventricular tissue [18].…”

Section: Discussionmentioning

confidence: 84%

Nitecapone is of benefit to functional performance in experimental heart transplantation

et al. 1997

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In heart transplantation, global ischemia of a graft is followed by reperfusion injury. The formation of oxygen free radicals induces arrhythmias and impairs functional recovery of the graft. This study was executed to evaluate the effect of the new antioxidant, nitecapone, on ischemia-reperfusion injury in heart transplantation in rats. Donor hearts were perfused and stored at +4 degrees C for 2 h in either Ringer's solution in the control group (C-group, n = 26) or Ringer's solution with nitecapone (NC) added (NC-group, n = 18). The donor aorta was anastomosed to the recipient's abdominal aorta and the pulmonary artery to the recipient's inferior vena cava. The grafts were classified into three categories based on the functional recovery. The rats in both groups were killed at 10, 30, or 60 min after release of the aortic clamp. Tissue samples for chemiluminescence were obtained from the left ventricle, the right ventricle, and the septum of the heart. All grafts in the NC-group (18/18) began beating after release of the aortic clamp, whereas only 50% (13/26) of the grafts in the C-group recovered (P < 0.0004). Chemiluminescence analysis showed lipid peroxidation values to be higher in the C-group than the NC-group up to 1 h after reperfusion. Also, the right ventricle samples showed lower chemiluminescence values in the NC-group than in the C-group. In conclusion, our results do not support the theory that different regions of the heart have different vulnerability to ischemia-reperfusion injuries. Nitecapone has a beneficial effect on the preservation of the grafts in terms of functional recovery.

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“…7 Currently, there is little that can be easily done to support the RV during periods of transient dysfunction. Ventricular assist devices are commonly used to support the circulation during both right-and left-heart failure.…”

Section: Discussionmentioning

confidence: 99%

Copulsation Balloon for Right Ventricular Assistance

1999

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Background-Options for management of acute right ventricular (RV) failure are limited. This report describes preliminary testing of a temporary RV assist device that acts by direct compression of the RV. The system comprises a pancake-shaped silicone balloon (5 cm diameter) connected to a drive console that delivers a 65-mL pneumatic pulse during cardiac systole. Methods and Results-Initial in vivo tests were performed on 6 pigs (weight, 41Ϯ4 kg). RV wall motion and stroke volume were monitored via transesophageal echocardiography. Acute RV failure was created by graded right coronary ligation, which yielded a 63% reduction in RV stroke volume (39.9Ϯ8.2 to 14.7Ϯ1.9 mL; PϽ0.002). We secured the balloon over the RV free wall by attaching it to the edges of the opened pericardium. The sternum was then reapproximated, and data were collected with the device off and on (every beat). Device placement had no deleterious effect on RV function. Balloon activation returned RV stroke volumes to normal (37.8Ϯ9.2 mL) and increased mean pulmonary artery pressures from 13Ϯ2 to 16Ϯ3 mm Hg (PϽ0.01). RV compression did not induce or exacerbate tricuspid regurgitation. Mean aortic pressure improved from postinfarction levels but did not return to normal. Conclusions-We conclude that the pulmonary circulation can be supported in the short term via cardiac compression and that balloon copulsation techniques for short-term RV failure should be tested in long-term models. (Circulation. 1999;99:2815-2818.)

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Treatment of perioperative low cardiac output syndrome

Cited by 32 publications

References 16 publications

A comparison of hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve repair / replacement for severe mitral stenosis

A comparison of hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve repair / replacement for severe mitral stenosis

Nitecapone is of benefit to functional performance in experimental heart transplantation

Copulsation Balloon for Right Ventricular Assistance

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